Validation of the Nottingham Hip Fracture Score (NHFS) to predict 30-day mortality following hip fracture in a Mexican population

Abstract

Introduction

Hip fractures in the elderly pose a significant clinical challenge, with high short-term mortality rates. The Nottingham Hip Fracture Score (NHFS) has proven useful in predicting 30-day mortality in European and Asian populations, but its validity in the Mexican population has not been widely assessed.

General objective

To validate the NHFS in predicting 30-day mortality following hip fracture in a Mexican population.

Methodology

An observational, longitudinal, and prospective study was conducted with 143 patients over 60 years of age with hip fractures treated surgically at Hospital General de Zona No. 16 of IMSS. NHFS was applied upon admission, and health status was verified 30 days post-surgery. The area under the ROC curve (AUC), sensitivity, specificity, and model calibration were calculated.

Results

The 30-day mortality rate was 14.7%. The NHFS had an AUC of 0.72, indicating moderate predictive capacity. A cutoff score of 3.5 yielded 85.7% sensitivity and 24% specificity. A higher cutoff of 4.5 improved specificity (45%) but reduced sensitivity (81%).

Conclusions

The NHFS is a useful tool for predicting 30-day mortality in the Mexican population with hip fractures, though its discriminative ability is moderate. A 3.5 cutoff is recommended when prioritizing sensitivity in clinical settings.