Revista Medica Del Instituto Mexicano Del Seguro Social · Mar 17, 2026
Predictive capacity of 30-day mortality using the Nottingham Scale in people aged 65 years or older with hip fracture in Michoacán
By Damian-Nuevo DG, Duarte-Flores JO, Méndez-Delgado JF
BACKGROUND: Hip fracture is a high-morbidity and high-mortality event in older adults. Early identification of the risk of death allows for optimized therapeutic decisions. OBJECTIVE: To evaluate the predictive capacity of the Nottingham Hip Fracture Scale (NHFS) for estimating 30-day mortality in individuals aged 65 years or older with a hip fracture. MATERIAL AND METHODS: A prospective, observational, longitudinal study was conducted in two IMSS hospitals in Michoacán, Mexico. Patients aged 65 years or older with a hip fracture were included. The NHFS score and its discriminative capacity were calculated using receiver operating characteristic (ROC) curve analysis. RESULTS: 169 patients were included; the 30-day mortality rate was 14.2%. Hemoglobin < 10 g/dL showed the strongest association with mortality, followed by in-hospital delirium and the NHFS score. In the multivariable model, severe anemia remained an independent predictor. The discriminative capacity of the scale was moderate (AUC = 0.746). The optimal cutoff point was ≥ 5 points. CONCLUSIONS: The Nottingham scale showed moderate discriminatory ability to predict 30-day mortality. Severe anemia emerged as an independent predictor of mortality.