Abstract：
A validation of the GeRi-Score on 120-day mortality, the impact of a pre-operative visit by a geriatrician, and timing of surgery on the outcome was conducted. The score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h or a preoperative geriatric visit.
OBJECTIVE: Numerous tools predict mortality among patients with hip fractures, but they include many variables, require time-consuming assessment, and are difficult to calculate. The GeRi-Score provides a quick method of pre-operative assessment. The aim of this study is to validate the score in the 120-day follow-up and determine the impact of a pre-operative visit by a geriatrician and timing of surgery on the patient outcome.
METHODS: A retrospective analysis of the AltersTraumaRegister DGU® from 2017 to 2021 was conducted, including all proximal femur fractures. The patients were divided into low-, moderate-, and high-risk groups based on the GeRi-Score. Mortality was analyzed using logistic regression. To determine the influence of the time to surgery and the preoperative visit by a geriatrician, matching was performed using the exact GeRi-Score, preoperative walking ability, type of fracture, and the time to surgery.
RESULTS: The study included 38,570 patients, divided into 12,673 low-risk, 18,338 moderate-risk, and 7,559 high-risk patients. The moderate-risk group had three times the mortality risk of the low-risk group (OR 3.19 (95% CI 2.68-3.79; p<0.001)), while the high-risk group had almost eight times the mortality risk than the low-risk group (OR 7.82 (95% CI 6.51-9.93; p<0.001)). No advantage was found for surgery within the first 24 h across all groups. There was a correlation of a preoperative geriatric visit and mortality showing an increase in the moderate and high-risk group on in-house mortality.
CONCLUSIONS: The GeRi-Score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h. The analysis did not demonstrate a benefit of the preoperative geriatric visit, but more data are needed.
OBJECTIVE: Numerous tools predict mortality among patients with hip fractures, but they include many variables, require time-consuming assessment, and are difficult to calculate. The GeRi-Score provides a quick method of pre-operative assessment. The aim of this study is to validate the score in the 120-day follow-up and determine the impact of a pre-operative visit by a geriatrician and timing of surgery on the patient outcome.
METHODS: A retrospective analysis of the AltersTraumaRegister DGU® from 2017 to 2021 was conducted, including all proximal femur fractures. The patients were divided into low-, moderate-, and high-risk groups based on the GeRi-Score. Mortality was analyzed using logistic regression. To determine the influence of the time to surgery and the preoperative visit by a geriatrician, matching was performed using the exact GeRi-Score, preoperative walking ability, type of fracture, and the time to surgery.
RESULTS: The study included 38,570 patients, divided into 12,673 low-risk, 18,338 moderate-risk, and 7,559 high-risk patients. The moderate-risk group had three times the mortality risk of the low-risk group (OR 3.19 (95% CI 2.68-3.79; p<0.001)), while the high-risk group had almost eight times the mortality risk than the low-risk group (OR 7.82 (95% CI 6.51-9.93; p<0.001)). No advantage was found for surgery within the first 24 h across all groups. There was a correlation of a preoperative geriatric visit and mortality showing an increase in the moderate and high-risk group on in-house mortality.
CONCLUSIONS: The GeRi-Score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h. The analysis did not demonstrate a benefit of the preoperative geriatric visit, but more data are needed.
摘要：
GeRi评分对120天死亡率的验证，老年儿科医生术前就诊的影响，并根据结果进行手术时机。该评分对120天死亡率具有预测价值。在24小时内手术或术前老年就诊均未发现优势。
目标：许多工具可以预测髋部骨折患者的死亡率，但是它们包括许多变量，需要耗时的评估，而且很难计算。GeRi评分提供了一种快速的术前评估方法。这项研究的目的是验证120天随访中的分数，并确定老年病学家术前就诊和手术时机对患者预后的影响。
方法：对2017年至2021年的AltersTraumaRegisterDGU®进行了回顾性分析，包括所有股骨近端骨折.患者被分为低，moderate-,和基于GeRi评分的高危人群。死亡率采用logistic回归分析。为了确定手术时间和术前访视的影响，使用精确的GeRi-Score进行匹配，术前步行能力，骨折类型,还有手术时间.
结果：该研究包括38,570名患者，分为12,673个低风险，18,338中等风险，和7559名高风险患者。中等风险组的死亡风险是低风险组的三倍（OR3.19（95％CI2.68-3.79；p<0.001）），而高危组的死亡风险几乎是低危组的8倍(OR7.82(95%CI6.51-9.93;p<0.001)).在所有组的前24小时内，手术均未发现优势。术前老年就诊和死亡率之间存在相关性，表明中度和高危人群的内部死亡率增加。
结论：GeRi评分对120天死亡率具有预测价值。在24小时内没有发现手术的优势。分析没有证明术前老年就诊的益处，但是需要更多的数据。
目标：许多工具可以预测髋部骨折患者的死亡率，但是它们包括许多变量，需要耗时的评估，而且很难计算。GeRi评分提供了一种快速的术前评估方法。这项研究的目的是验证120天随访中的分数，并确定老年病学家术前就诊和手术时机对患者预后的影响。
方法：对2017年至2021年的AltersTraumaRegisterDGU®进行了回顾性分析，包括所有股骨近端骨折.患者被分为低，moderate-,和基于GeRi评分的高危人群。死亡率采用logistic回归分析。为了确定手术时间和术前访视的影响，使用精确的GeRi-Score进行匹配，术前步行能力，骨折类型,还有手术时间.
结果：该研究包括38,570名患者，分为12,673个低风险，18,338中等风险，和7559名高风险患者。中等风险组的死亡风险是低风险组的三倍（OR3.19（95％CI2.68-3.79；p<0.001）），而高危组的死亡风险几乎是低危组的8倍(OR7.82(95%CI6.51-9.93;p<0.001)).在所有组的前24小时内，手术均未发现优势。术前老年就诊和死亡率之间存在相关性，表明中度和高危人群的内部死亡率增加。
结论：GeRi评分对120天死亡率具有预测价值。在24小时内没有发现手术的优势。分析没有证明术前老年就诊的益处，但是需要更多的数据。
