A Worsening Trend - Possum and NHFS in Patients with a Fractured Neck of Femur

With an aging population, an increasing number of patients are presenting with a fractured neck of femur (NOF) and concurrent multiple co-morbidities. Two scoring systems developed to predict morbidity; mortality and long-term outcomes are the Physiologica l and Operative Severity Score for enumeration of Mortality and morbidity score (POSSUM) and the Nottingham Hip Fracture Score (NHFS). Our study set out to identify the developing trends in patients presenting with a fractured NOF using the POSSUM score and NHFS. Data was retrospectively collected on all 139 patients operated on with a fractured neck of femur June and December 2011 and 2014. The results demonstrated a significant increase in both the POSSUM score and the NHFS between 2011 and 2014 (mean POSSUM score 35.39 vs. 40.19 respectively, P <0.001, 95% CI-6.94 to -2.65 and the mean NHFS 3.63 vs. 5.19 respectively, P <0.001, 95% CI -2.01 to -1.12). Our study demonstrated that patients presenting with a fractured NOF have worse physiological year on year. We believe that more research needs to be done to predict and prevent fractured NOF.