Nottingham Hip Fracture Score: longitudinal and multi-assessment
Nottingham Hip Fracture Score: longitudinal and multi-assessment
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DOI：
10.1093/bja/aes187
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发表时间：
2012-10-01
影响因子：
9.8
通讯作者：
Moran, C. G.
中科院分区：
文献类型：
--
作者：
Moppett, I. K.;Parker, M.;Moran, C. G.
2007年，诺丁汉髋部骨折评分(NHFS)在一个单一中心被开发和验证，作为30天死亡率的预测因子。随后，它被证明可以预测较长期和功能性的结果。我们希望评估NHFS预测其他中心结果的能力，并调查髋部骨折后随时间的变化。NHFS是根据来自三个英国髋部骨折单位的数据计算的：彼得堡(19922009)、布莱顿(20089)和诺丁汉(20009)，分别包括4804名、585名和1901名患者。通过随机选择50个数据集，用Logistic回归重新校正三个单位的NHFS至30天死亡率。校正使用HosmerLemesow拟合优度进行评估。NHFS值的中位数(四分位数范围)分别为彼得伯勒[4.0(16)]、布莱顿[5.0(37)]和诺丁汉[5.0(37)]。30d病死率与时间无关(R(2)0.05，P0.115)。NHFS epsilon 4患者的比例与时间呈弱相关(R(2)0.2，P0.003)。最初的NHFS方程高估了高危人群的死亡率。修正后的方程对所有三个中心都有很好的校正效果。{30天死亡率()100/1e([(5.012(NHFS0.481)]))}。医院并不是30天死亡率的预测因子，NHFS是在不同地理位置的英国中心髋部骨折修复术后30天死亡率的一个强有力的预测因子。
The Nottingham Hip Fracture Score (NHFS) was developed and validated in a single centre in 2007 as a predictor of 30 day mortality. It has subsequently been shown to predict longer term and functional outcomes. We wished to assess the ability of NHFS to predict outcomes in other centres and to investigate the change in outcome after hip fracture over time.The NHFS was calculated for all patients with data from three UK hip fracture units: Peterborough (19922009), Brighton (20089), and Nottingham (20009) including 4804, 585, and 1901 patients, respectively. The logistic regression was used to recalibrate the NHFS to 30 day mortality across the three units using a random selection of 50 of the data set. Calibration was assessed using the HosmerLemeshow goodness of fit.The median (inter-quartile range) NHFS values were Peterborough [4.0 (16)], Brighton [5.0 (37)], and Nottingham [5.0 (37)]. There was no correlation between 30 day mortality and time (R(2)0.05, P0.115). The proportion of patients with NHFS epsilon 4 showed a weak correlation with time (R(2)0.2, P0.003). The original NHFS equation overestimates mortality in the higher-risk groups. A modified equation shows good calibration for all three centres {30 day mortality ()100/1e([(5.012(NHFS0.481)])}. The hospital was not a predictor of 30 day mortality.The NHFS, with an updated equation, is a robust predictor of 30 day mortality after hip fracture repair in geographically distinct UK centres.