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The primary outcome of this study was to determine whether Age-adjusted Charlson Comorbidity Index (ACCI) is associated with increased fracture-related complications in neck of femur fractures treated by internal fixation. This was a cohort study between January 2014 to June 2018. All patients\u2009\u2265\u200950\u00a0years old with an acute neck of femur fracture after low-energy trauma fixed with cannulated hip screws were included and followed-up for 1\u00a0year at a tertiary centre. Primary outcome was to determine whether ACCI was associated with increased fracture-related complications. Secondary outcomes were revision rate, mortality, and function after surgery. Further analysis were performed within a \u201cyounger\u201d group (age 50\u201365) and \u201celder\u201d group (age\u2009&gt;\u200965), as displaced fractures (Garden Type III\/IV) were in \u201cyounger\u201d group. 233 hip fractures (68 males; 165 females) with a mean age of 73.04\u2009\u00b1\u200912.89 were included in the study. Surgical outcomes showed that the complication rate of hip screw fixation for all patients was 21.5% (50 patients) at 1\u00a0year. ACCI was significantly higher in all patients with complications (p\u2009=\u20090.000). Analysis within \u201cyounger\u201d (p\u2009=\u20090.000) and \u201celder\u201d groups (p\u2009=\u20090.006) both showed significance. Stepwise logistic regression modelling showed ACCI had positive correlation with complications with ACCI\u2009=\u20096 (OR 4.27, p\u2009=\u20090.02). R<jats:sup>2<\/jats:sup> values were comparatively better after controlled by Garden Type III\/IV at ACCI\u2009=\u20094 (OR 6.42 (1.70, 24.25), p\u2009=\u20090.01). The authors recommend that for patients with a Garden Type I\/II and ACCI\u2009\u2265\u20096 or a Garden Type III\/IV and ACCI\u2009\u2265\u20094, a direct arthroplasty surgery should be considered.<\/jats:p>","DOI":"10.1038\/s41598-022-08855-0","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T11:02:38Z","timestamp":1647687758000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["High Charlson Comorbidity Index Score is associated with early fracture-related complication for internal fixation of neck of femur fractures"],"prefix":"10.1038","volume":"12","author":[{"given":"Ronald Man Yeung","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Wang","family":"Chau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Yin","family":"Tso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing Hong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Wai Kit","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon Kwoon Ho","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing Hoi","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Ki Wai","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"issue":"12","key":"8855_CR1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","volume":"17","author":"O Johnell","year":"2006","unstructured":"Johnell, O. & Kanis, J. 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