Frailty plus Nottingham Hip Fracture Score to predict 90-day death risk after hip surgery

Incremental Prognostic Value of Frailty Beyond the Nottingham Hip Fracture Score for Predicting 90-Day Mortality After Hip Fracture Surgery: A Prospective Cohort Study

This project will test whether adding a quick frailty check (Clinical Frailty Scale) to the Nottingham Hip Fracture Score helps doctors better predict 90-day death risk for people aged 60 and older having hip fracture surgery.

Quick facts

• Study type: Observational
• Enrollment: 200 (estimated)
• Ages: 60 Years and up
• Sex: All
• Sponsor: Trakya University (other)
• Locations: 1 site (Edirne)
• Trial ID: NCT07481188 on ClinicalTrials.gov

What this trial studies

This is an observational cohort of patients aged 60 and older admitted with acute proximal femoral fractures who undergo surgical treatment at Trakya University. Investigators will record routine clinical data used to calculate the Nottingham Hip Fracture Score (NHFS) and measure pre-fracture frailty using the Clinical Frailty Scale (CFS). The study will compare how well the NHFS alone versus NHFS plus CFS predicts 90-day mortality using standard prediction metrics such as discrimination and calibration. No experimental treatments are given; care is per usual clinical practice and data are analyzed retrospectively or prospectively depending on enrollment.

Who should consider this trial

Good fit: Ideal candidates are adults aged 60 or older admitted for acute proximal femoral fracture (femoral neck, intertrochanteric, or subtrochanteric) who undergo surgical fixation and for whom NHFS and pre-fracture frailty data can be obtained.

Not a fit: Patients with pathological or periprosthetic fractures, high-energy/polytrauma, those managed non-operatively, or second hip fractures in the same patient during the study period are excluded and would not be expected to benefit from these prediction results.

Why it matters

Potential benefit: If successful, combining frailty assessment with the NHFS could help clinicians more accurately identify patients at high risk of death within 90 days and tailor perioperative planning and post-discharge support.

How similar studies have performed: Previous research has validated the NHFS for short-term mortality and shown frailty independently predicts worse post‑fracture outcomes, and combining frailty measures with risk scores has shown promise though this exact NHFS+CFS combination for 90-day mortality is less well established.

Eligibility criteria

Inclusion Criteria:

* Age 60 years or older
* Admission for acute proximal femoral fracture (femoral neck, intertrochanteric, or subtrochanteric fracture)
* Surgical treatment for hip fracture
* Ability to obtain clinical data required for NHFS and frailty assessment

Exclusion Criteria:

* Pathological fractures
* Periprosthetic fractures
* Hip fractures resulting from high-energy trauma or polytrauma
* Non-operative treatment
* Second hip fracture occurring in the same patient during the study period

Where this trial is running

Edirne

• Trakya University — Edirne, Turkey (Türkiye) (RECRUITING)

Study contacts

• Study coordinator: Eşref SELÇUK Asst Prof, MD

Conditions: Hip Fracture, Proximal Femur Fracture, Frailty, Hip fracture, Proximal femur fracture, Geriatric fracture, Mortality prediction