Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review

Rationale: Accurate peri-operative risk prediction is an essential element of clinical practice. Various risk stratification tools for assessing patients’ risk of mortality or morbidity have been developed and applied in clinical practice over the years. This review aims to outline essential charact...

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Main Authors: Marufu, Takawira C., Mannings, Alexa, Moppett, Iain K.
Format: Article
Published: Elsevier 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/40484/
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author Marufu, Takawira C.
Mannings, Alexa
Moppett, Iain K.
author_facet Marufu, Takawira C.
Mannings, Alexa
Moppett, Iain K.
author_sort Marufu, Takawira C.
building Nottingham Research Data Repository
collection Online Access
description Rationale: Accurate peri-operative risk prediction is an essential element of clinical practice. Various risk stratification tools for assessing patients’ risk of mortality or morbidity have been developed and applied in clinical practice over the years. This review aims to outline essential characteristics (predictive accuracy, objectivity, clinical utility) of currently available risk scoring tools for hip fracture patients. Methods: We searched eight databases; AMED, CINHAL, Clinical Trials.gov, Cochrane, DARE, EMBASE, MEDLINE and Web of Science for all relevant studies published until April 2015. We included published English language observational studies that considered the predictive accuracy of risk stratification tools for patients with fragility hip fracture. Results: After removal of duplicates, 15,620 studies were screened. Twenty-nine papers met the inclusion criteria, evaluating 25 risk stratification tools. Risk stratification tools considered in more than two studies were; ASA, CCI, E-PASS, NHFS and O-POSSUM. All tools were moderately accurate and validated in multiple studies; however there are some limitations to consider. The E-PASS and O-POSSUM are comprehensive but complex, and require intraoperative data making them a challenge for use on patient bedside. The ASA, CCI and NHFS are simple, easy and inexpensive using routinely available preoperative data. Contrary to the ASA and CCI which has subjective variables in addition to other limitations, the NHFS variables are all objective. Conclusion: In the search for a simple and inexpensive, easy to calculate, objective and accurate tool, the NHFS may be the most appropriate of the currently available scores for hip fracture patients. However more studies need to be undertaken before it becomes a national hip fracture risk stratification or audit tool of choice.
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spelling nottingham-404842020-05-04T17:20:54Z https://eprints.nottingham.ac.uk/40484/ Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review Marufu, Takawira C. Mannings, Alexa Moppett, Iain K. Rationale: Accurate peri-operative risk prediction is an essential element of clinical practice. Various risk stratification tools for assessing patients’ risk of mortality or morbidity have been developed and applied in clinical practice over the years. This review aims to outline essential characteristics (predictive accuracy, objectivity, clinical utility) of currently available risk scoring tools for hip fracture patients. Methods: We searched eight databases; AMED, CINHAL, Clinical Trials.gov, Cochrane, DARE, EMBASE, MEDLINE and Web of Science for all relevant studies published until April 2015. We included published English language observational studies that considered the predictive accuracy of risk stratification tools for patients with fragility hip fracture. Results: After removal of duplicates, 15,620 studies were screened. Twenty-nine papers met the inclusion criteria, evaluating 25 risk stratification tools. Risk stratification tools considered in more than two studies were; ASA, CCI, E-PASS, NHFS and O-POSSUM. All tools were moderately accurate and validated in multiple studies; however there are some limitations to consider. The E-PASS and O-POSSUM are comprehensive but complex, and require intraoperative data making them a challenge for use on patient bedside. The ASA, CCI and NHFS are simple, easy and inexpensive using routinely available preoperative data. Contrary to the ASA and CCI which has subjective variables in addition to other limitations, the NHFS variables are all objective. Conclusion: In the search for a simple and inexpensive, easy to calculate, objective and accurate tool, the NHFS may be the most appropriate of the currently available scores for hip fracture patients. However more studies need to be undertaken before it becomes a national hip fracture risk stratification or audit tool of choice. Elsevier 2015-12-01 Article PeerReviewed Marufu, Takawira C., Mannings, Alexa and Moppett, Iain K. (2015) Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review. Injury, 46 (12). pp. 2325-2334. ISSN 0020-1383 Fragility hip fracture ; Risk scoring tools ; Risk stratification tools ; Peri-operative ; Elderly http://www.sciencedirect.com/science/article/pii/S0020138315006270 doi:10.1016/j.injury.2015.10.025 doi:10.1016/j.injury.2015.10.025
spellingShingle Fragility hip fracture ; Risk scoring tools ; Risk stratification tools ; Peri-operative ; Elderly
Marufu, Takawira C.
Mannings, Alexa
Moppett, Iain K.
Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title_full Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title_fullStr Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title_full_unstemmed Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title_short Risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
title_sort risk scoring models for predicting peri-operative morbidity and mortality in people with fragility hip fractures: qualitative systematic review
topic Fragility hip fracture ; Risk scoring tools ; Risk stratification tools ; Peri-operative ; Elderly
url https://eprints.nottingham.ac.uk/40484/
https://eprints.nottingham.ac.uk/40484/
https://eprints.nottingham.ac.uk/40484/