gms | German Medical Science

Objectives: Objective: This study evaluated the use of nutrition score models in estimating short- to long-term mortality following proximal hip fracture in an elderly Austrian population.

Methods: Methods: Data from 1082 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of interest: Malnutrition Assessment (MNA), Grazer Malnutrition (GMS), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening (NRS). The performance of these models according to the risk prediction of short- to long-term mortality was assessed with a receiver operating characteristic curve (ROC).

Result: Results: The median age of participants was 82 years, and 68% were women. 6.1% of patients were deceased by 30 days and 15.2% by 180 days postoperatively. There was no significant difference between the models; the MNA had the largest area under the curve (AUC) for 30-day and 180-day mortality. Age, male gender, and albumin levels at admission 3,2g/l were identified as significant risk factors associated with a shorter time to death at 30 and 180 days postoperative (p < 0.001).

The mortality rate in the BMI groups showed no significant differences within 30 day survival, but after 3 months a BMI <18,5kg/m² was associated with a significant higher rate in mortality (21.84%) for all time periods.

Conclusion: Among the four scores, the MNA score could be best-suited clinically and showed the highest discriminative performance (AUC 0,71), although it was not specifically designed for the hip fracture population.