Prediction of postoperative mortality in elderly patients with hip fracture: are specific and geriatric scores better than general scores?

Editor—Elderly patients with hip fracture are at high risk of mortality. An accurate prediction of postoperative mortality is important for communicating information, in guiding decision-making, and management. Among preoperative scores, the ASA physical status score does not consider the surgery, makes no adjustment for age, and is subjective.¹ The PreOperative Score to predict PostOperative Mortality (POSPOM) is more accurate but has not been validated specifically in elderly patients.² Many geriatric scores focusing on multimorbidity, such as the Cumulative Illness Rating Scale (CIRS)³ and Charlson comorbidity index,⁴ have been proposed but not validated for postoperative prediction, and specific scores, such as the Nottingham Hip Fracture Score (NHFS), have also been proposed.⁵ We tested the hypothesis that specific or geriatric scores predict postoperative mortality better than general scores in this frail population.

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