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External validation of the discharge of hip fracture patients score

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Abstract

Purpose

This paper reports the external validation of a recently developed instrument, the Discharge of Hip fracture Patients score (DHP) that predicts discharge location on admission in patients living in their own home prior to hip fracture surgery.

Methods

The DHP (maximum score 100 points) was applied to 125 hip fracture patients aged 50 or more years admitted to an academic centre in the northern part of the Netherlands (Groningen cohort). The characteristics of this cohort, sensitivity, specificity and positive and negative predictive value (PPV, NPV) of the DHP for discharge to an alternative location (DAL) were calculated and compared with the original cohort of hip fracture patients from the western part of the Netherlands (Delft cohort). Scoring 30 points or higher indicated DAL.

Results

The Groningen cohort was younger compared to the Delft cohort, (mean age 75.4 vs. 78.5 years, P = 0.005) but was more often classified ASA III/IV (46.4 % vs. 25.2 %, P < 0.001). Sensitivity of the DHP for DAL in the Groningen cohort was 75 % (vs. 83.8 %), specificity of 66.7 % (vs. 64.7 %) and a PPV of 86.3 % (vs. 79.2 %), compared to the Delft cohort.

Conclusion

External validation of the DHP was successful; it predicted discharge location of hip fracture patients accurately in another Dutch cohort, the sensitivity for DAL was somewhat lower but the PPV higher. Therefore, the DHP score is a useful valid and easily applied instrument for general hip fracture populations.

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Abbreviations

DHP:

Discharge of Hip fracture Patients score

DAL:

Discharge to an Alternative Location

ASA:

American Society of Anesthesiologists

LOS:

Length of Stay

ADL:

Activities of Daily Living

SD:

Standard Deviation

OR:

Odds Ratio

CI:

Confidence Interval

ROC:

Receiver Operating characteristics Curve

AUC:

Area Under the Curve

PPV:

Positve Predictive Value

NPV:

Negative Predictive Value

IQR:

InterQuartile Range

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Acknowledgments

The work was supported by the Netherlands Organisation for scientific research (NGI/NWO; 05040202 and 050-060-810 Netherlands Consortium for Healthy Aging (NCHA)) and the seventh framework program MYOAGE (HEALTH-2007-2.4.5-10) and Reumafonds LRR.

No competing interests declared.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    Anne J. H. Vochteloo & Rob G. H. H. Nelissen

  2. Department of Orthopaedic Surgery, Reinier de Graaf Group, Delft, The Netherlands

    Anne J. H. Vochteloo, Rolf M. Bloem & Peter Pilot

  3. Department of Traumatology, University Medical Center Groningen, Groningen, The Netherlands

    Elvira R. Flikweert

  4. Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

    Wim E. Tuinebreijer

  5. Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands

    Andrea B. Maier

Authors
  1. Anne J. H. Vochteloo
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  2. Elvira R. Flikweert
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  3. Wim E. Tuinebreijer
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  4. Andrea B. Maier
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  5. Rolf M. Bloem
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  6. Peter Pilot
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  7. Rob G. H. H. Nelissen
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Corresponding author

Correspondence to Anne J. H. Vochteloo.

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Vochteloo, A.J.H., Flikweert, E.R., Tuinebreijer, W.E. et al. External validation of the discharge of hip fracture patients score. International Orthopaedics (SICOT) 37, 477–482 (2013). https://doi.org/10.1007/s00264-012-1763-7

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  • DOI: https://doi.org/10.1007/s00264-012-1763-7

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