ArticleAging clinical and experimental research2022
Comorbidity and the association with 1-year mortality in hip fracture patients: can the ASA score and the Charlson Comorbidity Index be used interchangeably?
Article in Aging clinical and experimental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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25 citing papers in PubMed, 37 citations in OpenAlex.
- Stray energy injury during robotic versus laparoscopic inguinal hernia repair: a randomized controlled trial.Surgical endoscopy · 2023Trial
- Fecal and urinary incontinence in older men with hip fracture: a geriatric syndrome with prognostic significance.European geriatric medicine · 2026Article
- Evaluation of Small and Large Language Models for Calculation of the ASA Score and Charlson Comorbidity Index in Orthopedic Surgical Patients: A Retrospective Concordance Analysis.Bioengineering (Basel, Switzerland) · 2026Article
- Factors associated with early follow-up attendance after geriatric hip fracture surgery.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Clinical Implications of ChatGPT-assisted Multimodal Pre-operative Assessment in Elderly Pertrochanteric Fracture Patients: An Exploratory Study.Journal of orthopaedic case reports · 2026Article
- Predictors of postoperative survival and mortality in nonagenarian surgical patients: a retrospective cohort study.BMC surgery · 2026Article
- Predictive value of shock indices in 30-day mortality for elderly hip fracture patients: a retrospective cohort study.Acta orthopaedica et traumatologica turcica · 2026Article
- Distinct comorbidity profiles and outcomes in asbestosis versus idiopathic pulmonary fibrosis: a 6-year prospective cohort study.BMC pulmonary medicine · 2026Article
- Does ongoing antithrombotic therapy increase the risk of revision after trochanteric fracture fixation? A retrospective cohort study with competing risk analyses.Archives of orthopaedic and trauma surgery · 2025Article
- Beyond the guidelines: outcomes of extremely delayed hip fracture surgery in elderly.BMC musculoskeletal disorders · 2025Article
- Surgical timing and clinical factor predicting in-hospital mortality in older adults with hip fractures: a neuronal network analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Observational
- Frailty as a determinant of mortality, surgical timing and hospital stay in proximal femur fractures: a retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Impact of dementia on post-hip fracture walking ability: a stratified analysis based on pre-fracture mobility in Swedish cohorts of older adults.BMC geriatrics · 2024Article
- Risk factors associated with 1-year mortality after osteoporotic hip fracture in Hawai'i: higher mortality risk among Native Hawaiians and other Pacific Islanders.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Outcome of Centenarians with Hip Fracture: An Analysis of the Registry for Geriatric Trauma (ATR-DGU).Journal of clinical medicine · 2024Article
- Associated factors of stress, urgency, and mixed urinary incontinence in a geriatric outpatient assessment of older women with hip fracture.European geriatric medicine · 2024Article
- Can we predict 1-year functional outcomes and mortality following hip fracture in middle-aged and geriatric patients at time of admission?Musculoskeletal surgery · 2024Article
- Hip Fracture Patterns, Hospital Course, and Mortality Differ Between Males and Females.Geriatric orthopaedic surgery & rehabilitation · 2024Article
- Comparison of different prognostic scores in estimating short- and long-term mortality in COVID-19 patients above 60 years old in a university hospital in Belgium.European geriatric medicine · 2023Observational
- Comorbidity and risk of infection among patients with hip fracture: a Danish population-based cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCharlson Comorbidity Index (CCI) has been suggested to be associated with mortality in hip fracture patients, to the same extent as more expensive and time-consuming tools. However, even CCI might be too time-consuming in a clinical setting.
aimTo investigate whether the American Society of Anaesthesiologists score (ASA score), a simple grading from the anaesthesiologist's examination, is comparable with CCI in the association with 1-year mortality after a hip fracture.
methodsThe study population was patients 60 + years registered in the Swedish Hip Fracture Registry with a first-time hip fracture between 1997 and 2017 (N = 165,596). The outcome was 1-year mortality, and the exposures were ASA score and CCI. The association between comorbidity and mortality was described with Kaplan-Meier curves and analyzed with Cox proportional hazards models.
resultsThe Kaplan-Meier curves showed a stepwise increase in mortality for increasing values of both ASA and CCI. The Hazard Ratios (HRs) for the highest ASA (4-5) were 3.8 (95% Confidence Interval 3.5-4.2) for women and 3.2 (2.8-3.6) for men in the fully adjusted models. Adjusted HRs for the highest CCI (4 +) were 3.6 (3.3-3.9) for women and 2.5 (2.3-2.7) for men. Reference was the lowest score value for both tools. The correlation between the tools was moderate.
conclusionsBoth ASA and CCI show a similar stepwise association with 1-year mortality in hip fracture patients, despite measuring different factors and capturing different individuals at risk. Since the ASA score is already accessible for health care staff, it might be preferable to aid in prioritizing vulnerable hip fracture patients at risk of adverse outcomes.
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