Multidimensional Frailty Scale (MFS) As A Early Predictor Of Short Term Outcomes In Elderly Patients With Proximal Hip Fractures: A Prospective Study

Abstract

Background: Proximal hip fractures represent a significant health concern among the elderly, with an annual global incidence of approximately 1.6 million, projected to rise to 6.3 million by 2050. These fractures are associated with high morbidity and mortality rates, necessitating an understanding of risk factors that influence outcomes.

Objective: This study aims to assess predictive risk factors for morbidity and mortality within 30 and 180 days post-fracture in older adults, utilizing the Multidimensional Frailty Score (MFS).

Methods: A prospective cohort study was conducted at JSS Hospital, Mysuru, enrolling 130 patients aged over 60 years with proximal hip fractures scheduled for surgical intervention. Data collection included demographics, comorbidities, and frailty assessments using the MFS, as well as functional evaluations via Barthel’s Index and Functional Ambulation Classification (FAC). Follow-ups were conducted at one and six months post-discharge.

Results: The cohort consisted predominantly of females (73.10%) aged 60-70 years. Mortality within six months was 21%, aligning with literature estimates. Higher MFS scores correlated with longer hospital stays and increased mortality risk, with an odds ratio of 3.42 for each unit increase in MFS. Significant improvements in functional scores were observed over time, but 71.70% of patients scored 0 on FAC at discharge. Serum albumin levels and Charlson Comorbidity Index (CCI) were also identified as critical factors influencing outcomes.

Conclusion: The study underscores the importance of comprehensive frailty assessments, particularly using the MFS, in predicting adverse outcomes in elderly patients with proximal femur fractures. The findings advocate for interdisciplinary care models and the integration of frailty evaluations into clinical practice to enhance decision-making and patient care.