ToolsCalculators
Nottingham Hip Fracture Score (NHFS)
Predicts 30-day mortality after hip fracture surgery.
Nottingham Hip Fracture Score (NHFS)
Age
Sex
Admission haemoglobin
Abbreviated Mental Test Score (AMTS)
Living in an institution (e.g. care/nursing home) before admission
2 or more comorbidities
Known malignancy (excluding non-melanoma skin cancer)
Result0 points
A score of 4 or less identifies a lower-risk group; in an independent cohort, 30-day survival was ~97% and 1-year survival ~84%.
- Risk group (cutoff 5)
- Low risk (<=4)
When to use
- Preoperative estimation of 30-day (and, with caveats, 1-year) mortality risk in patients admitted with a hip fracture, to inform shared decision-making and perioperative optimisation.
Formula
Sum of 7 predictors (range 0-10): age (66-85y=3, >=86y=4), male sex=1, haemoglobin <=10 g/dL=1, AMTS <=6/10=1, living in an institution=1, >=2 comorbidities=1, malignancy=1.
Pearls and pitfalls
- Should inform, not replace, individualised clinical and shared decision-making about surgery and perioperative care.
- A simple cut-point of >=5 has been used clinically to flag a high-risk group warranting closer perioperative input.