• Kristin Haugan, Jomar Klaksvik, and Olav A Foss.
• Orthopaedic Department, Orthopaedic Research Centre, St.Olavs Hospital, Trondheim University Hospital, Postboks 3250 Torgarden, 7006, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Faculty of Medicine and Health Sciences, N-7491 Trondheim, Norway. Electronic address: kristin.haugan@stolav.no.
• Injury. 2021 Aug 1; 52 (8): 2379-2383.

ObjectiveTo compare the Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists (ASA) Physical Status Classification used in two prediction models for 30-day mortality after hip fracture surgery.Study Design And SettingData from 3651 patients (mean age: 83 years) from a Norwegian University Hospital were retrospectively obtained and randomly divided into two cohorts: a model cohort (n = 1825) to develop two prediction models with CCI and ASA as the main predictors, and a validation cohort (n = 1826) to assess the predictive ability of both models. A receiver operating characteristic (ROC) curve determined the best model to predict mortality.ResultsArea under the ROC curve at 30 days was 0.726 (p = 0.988) for both the CCI- and ASA-model. The chosen cut-off-points on the ROC curve for CCI- and ASA-model corresponded to similar model sensitivities of 0.657 and specificities of 0.680 and 0.679, respectively. Hence, each model predicts correctly 66% (n = 96) of the mortalities and 68% (n = 1132 and n = 1131) of the survivals. 23% (n = 33) of the mortalities were predicted by neither model.ConclusionThe CCI- and ASA-model had equal predictive ability of 30-day mortality after hip fracture. Considering the effort involved in calculating Charlson Comorbidity Index score, the ASA score may be the preferred tool to predict the 30-day mortality after hip fracture.Copyright © 2021. Published by Elsevier Ltd.

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