Hip Fracture Geriatric (HIP-G) Index: Predicting 12-Month Mortality in Older Adults With Hip Fracture
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Hip fractures in older adults are associated with high mortality, disability, and functional decline. Although tools like the Multidimensional Prognostic Index (MPI) are validated for risk stratification, their use is limited in acute care due to time constraints and the need for comprehensive interviews. The aim of this study was to define a faster, clinically applicable tool for mortality prediction. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: The study included patients aged ≥65 years who were hospitalized for a fragility hip fracture within our Fracture Liaison Service program between March 2023 and March 2024. METHODS: Clinical, laboratory, and multidimensional geriatric assessment data were collected at admission. One-year mortality was the primary outcome. Predictors of mortality were identified using multivariable Cox regression, and a prognostic score-HIP fracture Geriatric Index (HIP-G Index)-was developed. Its performance was compared with the MPI and Charlson Comorbidity Index (CCI) using receiver operating characteristic analysis and the Hosmer-Lemeshow test. RESULTS: We included 592 patients with a mean age of 84.4 years; 71.5% were female. At 12 months, 129 patients (21.8%) had died. The HIP-G Index (based on creatinine, cognitive, nutritional domains, and comorbidities) showed superior predictive accuracy [area under the curve (AUC) = 0.799] vs MPI (AUC = 0.734) and CCI (AUC = 0.678, P < .001). The model was well-calibrated (Hosmer-Lemeshow P = .24). A simplified categorical score (0-4 points) stratified patients into low-, moderate-, and high-risk groups, with corresponding hazard ratios of 7.2 and 16.9 for mortality (P < .001). Kaplan-Meier analysis confirmed significant survival differences between risk groups. CONCLUSIONS AND IMPLICATIONS: The HIP-G Index is a valid, user-friendly tool for predicting 1-year mortality in older adults with hip fracture and may support decision making in time-constrained clinical settings.
Authors: Chiara Ceolin, Davide Cannavò, Stefania Sella, Valentina Camozzi, Anna Bertocco, Marco Onofrio Torres, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb, Francesca Guidolin, Maria Grazia Rodà, Michele Cannito, Antonio Berizzi, Andrea Venturin, Vito Cianci, Elisa Pala, Mariachiara Cerchiaro, Deris Gianni Boemo, Maria Vittoria Nesoti, Gaetano Paride Arcidiacono, Gaetano Paride Arcidiacono, Paolo Simioni, Pietro Ruggieri, Giuseppe Sergi, Sandro Giannini, Marina De Rui, Carlotta Andaloro, Gaetano Paride Arcidiacono, Gaetano Paride Arcidiacono, Giulia Bano, Antonio Berizzi, Anna Bertocco, Sara Bertolino, Deris Gianni Boemo, Ester Bukli, Valentina Camozzi, Davide Cannavò, Michele Cannito, Alberta Cecchinato, Chiara Ceolin, Mariachiara Cerchiaro, Vito Cianci, Giacomo Contini, Martina Dall’Agnol, Marina De Rui, Mario Degan, Marta Dianin, Martin Diogo, Michela Ferrarese, Claudia Finamoni, Sandro Giannini, Francesca Guidolin, Mario Rosario Lo Storto, Elena Marigo, Stefano Masiero, Caterina Mian, Maria Vittoria Nesoti, Elisa Pala, Mor Peleg Falb, Alessandra Pizziol, Maria Grazia Rodà, Giovanna Romanato, Paola Romano, Pietro Ruggieri, Cristina Russo, Sandro Savino, Stefania Sella, Giuseppe Sergi, Paolo Simioni, Cristina Simonato, Giulia Termini, Michele Tessarin, Marco Onofrio Torres, Andrea Venturin, Franz Villanova, Federica Vilona, Hillary Veronese, Francesca Zanchetta, Chiara Ziliotto
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,370
OpenAlex ID: W4415349948