{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:54:50Z","timestamp":1790142890256,"version":"4.0.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Geriatr Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Pre-operative scores based on patient characteristics are commonly used to predict hip fracture outcomes. Mobility, an indicator of pre-operative function, has been neglected as a potential predictor. We assessed the ability of pre-fracture mobility to predict post-operative outcomes following hip fracture.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We analysed prospectively collected data from hip fracture surgery patients at a large-volume trauma unit. Mobility was classified into four groups. Post-operative outcomes studied were mortality and residence at 30 days, medical complications within 30- or 60-days post-operatively, and prolonged length of stay (LOS, \u2265\u200928\u00a0days). We performed multivariate regression analyses adjusting for age and sex to assess the discriminative ability of the Nottingham Hip Fracture Score (NHFS), with and without mobility, for predicting outcomes using the area under the receiver operating characteristic curve (AUROC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>1919 patients were included, mean age 82.6 (SD 8.2); 1357 (70.7%) were women. Multivariate analysis demonstrated patients with worse mobility had a 1.7\u20135.5-fold higher 30-day mortality (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001), and 1.9\u20133.2-fold higher likelihood of prolonged LOS (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001). Worse mobility was associated with a 2.3\u20133.8-fold higher likelihood of living in a care home at 30-days post-operatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a 1.3\u20132.0-fold higher likelihood of complications within 30 days (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001). Addition of mobility improved NHFS discrimination for discharge location, AUROC NHFS 0.755 [0.733\u20130.777] to NHFS\u2009+\u2009mobility 0.808 [0.789\u20130.828], and LOS, AUROC NHFS 0.584 [0.557\u20130.611] to NHFS\u2009+\u2009mobility 0.616 [0.590\u20130.643].<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Incorporating mobility assessment into risk scores may improve casemix adjustment, prognostication following hip fracture, and identify high-risk patient groups requiring enhanced post-operative care at admission.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s41999-023-00767-0","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T16:02:54Z","timestamp":1680278574000},"page":"285-293","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Using pre-fracture mobility to augment prediction of post-operative outcomes in hip fracture"],"prefix":"10.1007","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8679-1290","authenticated-orcid":false,"given":"Thomas A.","family":"Stubbs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0308-6674","authenticated-orcid":false,"given":"William J.","family":"Doherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Chaplin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Langford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike R.","family":"Reed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-6457","authenticated-orcid":false,"given":"Avan A.","family":"Sayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-0990","authenticated-orcid":false,"given":"Miles D.","family":"Witham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4449-014X","authenticated-orcid":false,"given":"Antony K.","family":"Sorial","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"767_CR1","volume-title":"Facing new challenges\u2014the NHFS report on 2020 (January\u2013December 2020)","author":"Royal College of Physicians","year":"2021","unstructured":"Royal College of Physicians (2021) Facing new challenges\u2014the NHFS report on 2020 (January\u2013December 2020). RCP, London"},{"key":"767_CR2","volume-title":"The challenge of the next decade: are hip fracture services ready? A review of data from the National Hip Fracture Database (January\u2013December 2019)","author":"Royal College of Physicians","year":"2021","unstructured":"Royal College of Physicians (2021) The challenge of the next decade: are hip fracture services ready? A review of data from the National Hip Fracture Database (January\u2013December 2019). RCP, London"},{"issue":"2","key":"767_CR3","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s00198-015-3277-9","volume":"27","author":"J Leal","year":"2016","unstructured":"Leal J, Gray AM, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK et al (2016) Impact of hip fracture on hospital care costs: a population-based study. Osteoporos Int 27(2):549\u2013558","journal-title":"Osteoporos Int"},{"issue":"1","key":"767_CR4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.injury.2004.06.015","volume":"36","author":"TM Lawrence","year":"2005","unstructured":"Lawrence TM, White CT, Wenn R, Moran CG (2005) The current hospital costs of treating hip fractures. Injury 36(1):88\u201391","journal-title":"Injury"},{"issue":"3","key":"767_CR5","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.jamda.2020.07.013","volume":"22","author":"WJ Doherty","year":"2021","unstructured":"Doherty WJ, Stubbs TA, Chaplin A, Reed MR, Sayer AA, Witham MD et al (2021) Prediction of postoperative outcomes following hip fracture surgery: independent validation and recalibration of the Nottingham Hip Fracture Score. J Am Med Dir Assoc 22(3):663\u20139.e2","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"767_CR6","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s00774-020-01187-x","volume":"39","author":"G Thorne","year":"2021","unstructured":"Thorne G, Hodgson L (2021) Performance of the Nottingham Hip Fracture Score and Clinical Frailty Scale as predictors of short and long-term outcomes: a dual-centre 3-year observational study of hip fracture patients. J Bone Miner Metab 39(3):494\u2013500","journal-title":"J Bone Miner Metab"},{"issue":"6","key":"767_CR7","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1016\/j.injury.2021.01.004","volume":"52","author":"HJ Schuijt","year":"2021","unstructured":"Schuijt HJ, Morin ML, Allen E, Weaver MJ (2021) Does the frailty index predict discharge disposition and length of stay at the hospital and rehabilitation facilities? Injury 52(6):1384\u20131389","journal-title":"Injury"},{"key":"767_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2020.115327","volume":"136","author":"RN Jorissen","year":"2020","unstructured":"Jorissen RN, Lang C, Visvanathan R, Crotty M, Inacio MC (2020) The effect of frailty on outcomes of surgically treated hip fractures in older people. Bone 136:115327","journal-title":"Bone"},{"issue":"3","key":"767_CR9","doi-asserted-by":"publisher","first-page":"200","DOI":"10.2106\/JBJS.16.00734","volume":"99","author":"ME Deren","year":"2017","unstructured":"Deren ME, Babu J, Cohen EM, Machan J, Born CT, Hayda R (2017) Increased mortality in elderly patients with sarcopenia and acetabular fractures. J Bone Joint Surg Am 99(3):200\u2013206","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"767_CR10","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1136\/jcp.56.6.426","volume":"56","author":"MA Crook","year":"2003","unstructured":"Crook MA (2003) The Caldicott report and patient confidentiality. J Clin Pathol 56(6):426","journal-title":"J Clin Pathol"},{"key":"767_CR11","unstructured":"World Health Organisation (2004) ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd edn. World Health Organisation. https:\/\/apps.who.int\/iris\/handle\/10665\/42980"},{"key":"767_CR12","unstructured":"NHS Digital (2009) NHS Classifications OPCS-4 2009. https:\/\/isd.digital.nhs.uk\/trud3\/user\/guest\/group\/0\/pack\/10"},{"key":"767_CR13","doi-asserted-by":"publisher","first-page":"7665","DOI":"10.12659\/MSM.909943","volume":"24","author":"K Tilkeridis","year":"2018","unstructured":"Tilkeridis K, Ververidis A, Kiziridis G, Kotzamitelos D, Galiatsatos D, Mavropoulos R et al (2018) Validity of Nottingham Hip Fracture Score in different health systems and a new modified version validated to the Greek population. Med Sci Monit 24:7665\u20137672","journal-title":"Med Sci Monit"},{"key":"767_CR14","volume":"2021","author":"TJ Hjelholt","year":"2021","unstructured":"Hjelholt TJ, Johnsen SP, Brynningsen PK, Knudsen JS, Prieto-Alhambra D, Pedersen AB (2021) Development and validation of a model for predicting mortality in patients with hip fracture. Age Ageing 2021:afab233","journal-title":"Age Ageing"},{"issue":"8","key":"767_CR15","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1191\/0269215506cre987oa","volume":"20","author":"NB Foss","year":"2006","unstructured":"Foss NB, Kristensen MT, Kehlet H (2006) Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score. Clin Rehabil 20(8):701\u2013708","journal-title":"Clin Rehabil"},{"issue":"10","key":"767_CR16","doi-asserted-by":"publisher","first-page":"2138","DOI":"10.1016\/j.injury.2016.07.022","volume":"47","author":"WS Nijmeijer","year":"2016","unstructured":"Nijmeijer WS, Folbert EC, Vermeer M, Slaets JP, Hegeman JH (2016) Prediction of early mortality following hip fracture surgery in frail elderly: the Almelo Hip Fracture Score (AHFS). Injury 47(10):2138\u20132143","journal-title":"Injury"},{"issue":"1","key":"767_CR17","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s41999-018-0146-z","volume":"10","author":"P Di Giovanni","year":"2019","unstructured":"Di Giovanni P, Di Martino G, Zecca IAL, Porfilio I, Romano F, Staniscia T (2019) Outcomes comparison between hip fracture surgery and elective hip replacement: a propensity score-matched analysis on administrative data. Eur Geriatr Med 10(1):61\u201366","journal-title":"Eur Geriatr Med"},{"issue":"12","key":"767_CR18","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1302\/0301-620X.102B12.BJJ-2020-0367.R1","volume":"102-B","author":"T Khan","year":"2020","unstructured":"Khan T, Middleton R, Alvand A, Manktelow ARJ, Scammell BE, Ollivere BJ (2020) High mortality following revision hip arthroplasty for periprosthetic femoral fracture. Bone Joint J 102-B(12):1670\u20131674","journal-title":"Bone Joint J"},{"issue":"5","key":"767_CR19","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1016\/j.arth.2020.01.003","volume":"35","author":"TB Amen","year":"2020","unstructured":"Amen TB, Varady NH, Hayden BL, Chen AF (2020) Pathologic versus native hip fractures: comparing 30-day mortality and short-term complication profiles. J Arthroplast 35(5):1194\u20131199","journal-title":"J Arthroplast"},{"issue":"4","key":"767_CR20","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1093\/bja\/aen236","volume":"101","author":"M Maxwell","year":"2008","unstructured":"Maxwell M, Moran C, Moppett I (2008) Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth 101(4):511\u2013517","journal-title":"Br J Anaesth"},{"issue":"2","key":"767_CR21","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s11420-012-9279-7","volume":"8","author":"F Comba","year":"2012","unstructured":"Comba F, Alonso Hidalgo I, Buttaro M, Piccaluga F (2012) Risk factor analysis for 30-day mortality after primary THA in a single institution. HSS J 8(2):111\u2013115","journal-title":"HSS J"},{"issue":"1","key":"767_CR22","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3109\/17453674.2012.752691","volume":"84","author":"E J\u00e4msen","year":"2013","unstructured":"J\u00e4msen E, Puolakka T, Eskelinen A, J\u00e4ntti P, Kalliovalkama J, Nieminen J et al (2013) Predictors of mortality following primary hip and knee replacement in the aged. A single-center analysis of 1,998 primary hip and knee replacements for primary osteoarthritis. Acta Orthop 84(1):44\u201353","journal-title":"Acta Orthop"},{"issue":"2","key":"767_CR23","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1097\/ALN.0b013e3181e08e97","volume":"113","author":"DR Spahn","year":"2010","unstructured":"Spahn DR (2010) Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology 113(2):482\u2013495","journal-title":"Anesthesiology"},{"key":"767_CR24","unstructured":"Royal College of Physicians (2018) National Hip Fracture Database annual report 2018"},{"issue":"10","key":"767_CR25","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1046\/j.1440-1622.1999.01673.x","volume":"69","author":"AK Cree","year":"1999","unstructured":"Cree AK, Nade S (1999) How to predict return to the community after fractured proximal femur in the elderly. Aust N Z J Surg 69(10):723\u2013725","journal-title":"Aust N Z J Surg"},{"issue":"6","key":"767_CR26","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1308\/rcsann.2017.0021","volume":"99","author":"O Salar","year":"2017","unstructured":"Salar O, Baker PN, Forward DP, Ollivere BJ, Weerasuriya N, Moppett IK et al (2017) Predictors of direct home discharge following fractured neck of femur. Ann R Coll Surg Engl 99(6):444\u2013451","journal-title":"Ann R Coll Surg Engl"},{"issue":"2","key":"767_CR27","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1007\/s41999-021-00556-7","volume":"13","author":"H Ferris","year":"2022","unstructured":"Ferris H, Brent L, Sorensen J, Ahern E, Coughlan T (2022) Discharge destination after hip fracture: findings from the Irish hip fracture database. Eur Geriatr Med 13(2):415\u2013424","journal-title":"Eur Geriatr Med"},{"issue":"4","key":"767_CR28","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s41999-020-00317-y","volume":"11","author":"H Ferris","year":"2020","unstructured":"Ferris H, Brent L, Coughlan T (2020) Early mobilisation reduces the risk of in-hospital mortality following hip fracture. Eur Geriatr Med 11(4):527\u2013533","journal-title":"Eur Geriatr Med"},{"issue":"2","key":"767_CR29","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1016\/j.injury.2015.12.024","volume":"47","author":"MN Sharrock","year":"2016","unstructured":"Sharrock MN, Davies RM, Smith P, Lovell ME (2016) Factors that affect fractured neck of femur outcome: clinical commissioning groups influence length of stay and discharge destination. Injury 47(2):444\u2013447","journal-title":"Injury"},{"issue":"3","key":"767_CR30","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1093\/ageing\/afr142","volume":"41","author":"I Moppett","year":"2011","unstructured":"Moppett I, Wiles M, Moran C, Sahota O (2011) The Nottingham Hip Fracture Score as a predictor of early discharge following fractured neck of femur. Age Ageing 41(3):322\u2013326","journal-title":"Age Ageing"},{"issue":"10","key":"767_CR31","first-page":"11014","volume":"13","author":"Z Chen","year":"2021","unstructured":"Chen Z, Song T, Li Y, Luo L, Li Z, Zhao Q (2021) The pulmonary infection risk factors in long-term bedridden patients: a meta-analysis. Am J Transl Res 13(10):11014\u201311025","journal-title":"Am J Transl Res"},{"issue":"4","key":"767_CR32","doi-asserted-by":"publisher","first-page":"1093-i","DOI":"10.1093\/ije\/dyx015","volume":"46","author":"A Herbert","year":"2017","unstructured":"Herbert A, Wijlaars L, Zylbersztejn A, Cromwell D, Hardelid P (2017) Data resource profile: hospital episode statistics admitted patient care (HES APC). Int J Epidemiol 46(4):1093\u2013i","journal-title":"Int J Epidemiol"},{"issue":"9","key":"767_CR33","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1136\/bmjqs-2015-003932","volume":"24","author":"M Parthasarathy","year":"2015","unstructured":"Parthasarathy M, Reid V, Pyne L, Groot-Wassink T (2015) Are we recording postoperative complications correctly? Comparison of NHS Hospital Episode Statistics with the American College of Surgeons National Surgical Quality Improvement Program. BMJ Qual Saf 24(9):594\u2013602","journal-title":"BMJ Qual Saf"},{"key":"767_CR34","unstructured":"Ministry of Housing Communities and Local Government (2019) The English Indices of Deprivation 2019 (IoD2019)"},{"issue":"1","key":"767_CR35","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s00198-017-4238-2","volume":"29","author":"A Bhimjiyani","year":"2018","unstructured":"Bhimjiyani A, Neuburger J, Jones T, Ben-Shlomo Y, Gregson CL (2018) The effect of social deprivation on hip fracture incidence in England has not changed over 14 years: an analysis of the English Hospital Episodes Statistics (2001\u20132015). Osteoporos Int 29(1):115\u2013124","journal-title":"Osteoporos Int"},{"issue":"9","key":"767_CR36","doi-asserted-by":"publisher","first-page":"2727","DOI":"10.1007\/s00198-016-3608-5","volume":"27","author":"K Thorne","year":"2016","unstructured":"Thorne K, Johansen A, Akbari A, Williams JG, Roberts SE (2016) The impact of social deprivation on mortality following hip fracture in England and Wales: a record linkage study. Osteoporos Int 27(9):2727\u20132737","journal-title":"Osteoporos Int"}],"container-title":["European Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-023-00767-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41999-023-00767-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-023-00767-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T09:49:59Z","timestamp":1681811399000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41999-023-00767-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["767"],"URL":"https:\/\/doi.org\/10.1007\/s41999-023-00767-0","relation":{},"ISSN":["1878-7657"],"issn-type":[{"value":"1878-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,31]]},"assertion":[{"value":"2 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All study data were managed in accordance with Caldicott principles.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As the analyses used only routinely collected patient data, and no additional data collection was undertaken, the study was deemed not to require evaluation by an ethics committee.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}