Functional status geriatric scores: Single-handed tools for 30-day mortality risk after hip fracture

Abstract

Background: The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to appraise the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale registered in the Comprehensive Geriatric Assessment at admission on the of 30-day death probability after hip fracture surgery. Methods: Prospective study including 899 hip fracture patients over 65. Bed-ridden, non-surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ2, U-Mann Whitney and we performed binary logistic regression and equal tailed Jeffreys 95% CI for risk assessment. P<0.05 was considered statistically significant. Results: We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR=0.986 [0.975–0.996], p=0.010), Katz Index (OR=1.254 [1.089–1.444], p=0.002), Lawton-Brody Index (OR=0.885 [0.788–0.992], p=0.037), and Physical Red Cross Scale (OR=1.483 [1.-094–2.011], p=0.011) with the 30-day mortality of patients after hip fracture surgery. We also validated the Barthel Index inflection point (0–55) (ORBI(0–55)=2.428 [1.379–4.275], p=0.002) and Katz Index inflection point (A-B) (ORKI(A-B)=0.493 [0.273–0.891], p=0.019) for the assessment of the highest risked patients. Conclusion: The geriatric functional status scores would be useful multifunctional and standalone tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.