Predictors of Fisher et al for In-Hospital Mortality of an Older Patient with Hip Fracture

Description

Fisher et al identified risk factors on admission that are associated with in-hospital mortality for an older adult with hip fracture. These can help to identify a patient who may benefit from more aggressive management. The authors are from The Camberra Hospital, Frankston Hospital and Australian National University

Patient selection: >= 60 years of age with hip fracture

Parameters on admission:

(1) serum albumin in g/L

(2) ratio of serum GGT to ALT

(3) parathyroid hormone in pmol/L

(4) 25(OH)-vitamin D in nmol/L

(5) history of myocardial infarction

(6) GFR in mL per min per 1.73 square meters

(7) chronic obstructive pulmonary disease (COPD)

Parameter	Finding	Points
serum albumin	>= 33 g/L	0
	< 33 g/L	1
ratio of GGT to ALT	<= 2.5	0
	> 2.5	1
parathyroid hormone	<= 6.8 pmol/L	0
	> 6.8 pmol/L	1
25(OH) vitamin D	>= 25 nmol/L	0
	< 25 nmol/L	1
history of myocardial infarction	no	0
	yes	1
GFR	>= 60	0
	< 60	1
COPD	no	0
	yes	1

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the greater the risk of in-hospital mortality.

Score	OR for In-Hospital Mortality
2	3.1
3	6.2
>= 4	11.2

Performance:

• The negative predictive value for >= 2 factors was 98.5%.

• The sensitivity for >= 4 risk factors is 73% with specificity 83%, with AUC 0.84.

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Predictors of Fisher et al for In-Hospital Mortality of an Older Patient with Hip Fracture

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