Validation of the American College of Surgeons National Surgical Quality Improvement Programme surgical risk calculator in predicting geriatric outcomes in patients with neck of femur fractures
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Hip fractures are associated with poor functional outcomes and increased mortality. The American College of Surgeons National Surgical Quality Improvement Programme (NSQIP) surgical risk calculator is an open access tool that estimates the probability of postoperative outcomes. AIMS: To externally validate the calculator in predicting geriatric outcomes (delirium, functional decline, pressure injury), 30-day inpatient mortality and discharge destination in patients aged 65 and older undergoing surgical fixation of neck of femur fractures. METHODS: A retrospective single-centre cohort study of patients admitted from July 2022 to June 2023 to a large, metropolitan health service in Melbourne, Australia, was conducted. The calculator's performance was analysed using the area under the receiver operating characteristic curve (AUC), the Hosmer-Lemeshow test and the Brier score. RESULTS: We included 305 patients in the study. Mean age was 82.4 ± 7.8 years and 215 (70.5%) were female. The calculator performed well for predicting delirium (AUC 0.859, 95% CI 0.811-0.902, Brier score 0.150), functional decline (AUC 0.883, 95% CI 0.826-0.935, Brier score 0.120) and mortality (AUC 0.854, 95% CI 0.774-0.917, Brier score 0.065). Results from the Hosmer-Lemeshow test for all of these outcomes demonstrated good calibration. The calculator had reduced performance in predicting discharge destination and pressure-injury risk. CONCLUSION: The calculator is a moderately reliable predictor of delirium, functional decline and inpatient mortality in older patients who undergo hip fracture surgery. Further prospective research is required to validate it across other Australian healthcare settings.
Source: Internal Medicine Journal
DOI: 10.1111/imj.70311
Authors: Tessa Lo, Shiu Lai, Tanita Botha, Stephanie Than
Institutions: Western Health, Deakin University, The University of Melbourne
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,570
OpenAlex ID: W7117355625