{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:27:33Z","timestamp":1790605653791,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T00:00:00Z","timestamp":1524441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about accuracy of common risk prediction scores in elderly patients suffering from hip fractures. The objective of this study was to investigate accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (<jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content>) score, Portsmouth\u2010<jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content> (P\u2010<jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content>) score and the Nottingham Hip Fracture Score (<jats:styled-content style=\"fixed-case\">NHFS<\/jats:styled-content>) for prediction of mortality and morbidity in this patient group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective single centre observational study on 997 patients suffering out\u2010of\u2010hospital cervical, trochanteric or subtrochanteric fracture of the neck of the femur. Calibration and discrimination was assessed by calculating the ratio of observed to expected events (O:E) and areas under receiver operating characteristics curves (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 30\u2010day mortality was 6.2% and complications, as defined by <jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content>, occurred in 41% of the patients. Overall O:E ratios for <jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content>, P\u2010<jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NHFS<\/jats:styled-content> scores for 30\u2010day mortality were 0.90, 0.98, and 0.79 respectively. The models underestimated mortality in the lower risk bands and overestimated mortality in the higher risk bands. In contrast, <jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content> predicted morbidity well with O:E ratios close to unity in most risk bands. The areas under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curves for the scoring systems was 0.60\u20100.67.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">POSSUM<\/jats:styled-content> score and <jats:styled-content style=\"fixed-case\">NHFS<\/jats:styled-content> show moderate calibration and poor discrimination in this cohort. The results suggest that mortality and morbidity in hip fracture patients are largely dependent on factors that are not included in these scores.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13131","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T04:51:53Z","timestamp":1524545513000},"page":"1057-1063","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden \u2014 A prospective observational study"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9844-8628","authenticated-orcid":false,"given":"M. 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