Hip FractureNCT07481188
Frailty and Nottingham Hip Fracture Score for Predicting 90-Day Mortality After Hip Fracture Surgery
An observational study of Hip Fracture and Proximal Femur Fracture, run by Trakya University at 1 site in Turkey (Türkiye).
Trial summary
Hip fractures are serious injuries that occur mostly in older adults. Many people experience health problems or may die in the months after surgery. Doctors try to identify patients who have a higher risk of poor outcomes as early as possible. Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Hip Fracture, Proximal Femur Fracture, Frailty
- How many people
- 200 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Mar 2026to 15 Mar 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Older adults admitted with proximal femoral fractures who undergo surgical treatment at Trakya University Hospital.
Who may be able to join
- Age 60 years or older
- Admission for acute proximal femoral fracture (femoral neck, intertrochanteric, or subtrochanteric fracture)
- Surgical treatment for hip fracture
- Ability to obtain clinical data required for NHFS and frailty assessment
Who cannot join
- Pathological fractures
- Periprosthetic fractures
- Hip fractures resulting from high-energy trauma or polytrauma
- Non-operative treatment
- Second hip fracture occurring in the same patient during the study period
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Trakya University
Edirne
Eşref Selçuk Asst Prof Selçuk, MD, +905356319974
About this study
Official title: Incremental Prognostic Value of Frailty Beyond the Nottingham Hip Fracture Score for Predicting 90-Day Mortality After Hip Fracture Surgery: A Prospective Cohort Study
Hip fractures are serious injuries that occur mostly in older adults. Many people experience health problems or may die in the months after surgery. Doctors try to identify patients who have a higher risk of poor outcomes as early as possible.
Doctors often use the Nottingham Hip Fracture Score (NHFS) to estimate the risk of death after hip fracture surgery. This score uses information such as age and other health conditions. However, it does not fully reflect how physically vulnerable a person may be.
Read more
Another important concept is frailty. Frailty describes how strong or weak a person's overall health and physical reserve are. In this study, frailty will be measured using the Clinical Frailty Scale (CFS). This scale evaluates a person's level of independence and physical function before the fracture.
The purpose of this study is to determine whether measuring frailty can improve the prediction of death after hip fracture surgery.
Older adults with hip fractures who undergo surgery will be invited to participate in the study. Researchers plan to include about 200 participants or all eligible patients enrolled within one year, whichever occurs first. Health information that is already collected during routine hospital care will be recorded. Frailty will be assessed when participants are admitted to the hospital.
Participants will be followed for 30 days and 90 days after surgery to determine survival status. Researchers will review hospital records and may contact participants or their relatives by phone if needed.
The results of this study may help doctors better identify patients at higher risk and improve care planning after hip fracture surgery.
Read the detailed description
Hip fractures in older adults are associated with substantial morbidity, loss of independence, and high early mortality. Identifying patients at increased risk of poor outcomes is therefore an important part of perioperative care and treatment planning. Several clinical tools have been developed to estimate short-term mortality following hip fracture surgery. Among these, the Nottingham Hip Fracture Score (NHFS) is widely used and has been validated in multiple patient cohorts.
The NHFS is calculated using routinely available clinical variables such as age, comorbid conditions, and laboratory values. Although this score performs reasonably well in predicting short-term mortality, it mainly reflects comorbidity burden and demographic factors. It does not directly measure the patient's physiological reserve or overall vulnerability to stress.
Frailty has gained increasing attention as an important determinant of surgical outcomes in older adults. Frailty represents a state of reduced physiological reserve that limits the ability to recover from acute health events such as trauma or surgery. The Clinical Frailty Scale (CFS) is a practical bedside tool that classifies frailty based on functional status and the level of independence prior to illness or injury. Because it can be applied quickly in routine clinical settings, it has been used in various studies evaluating outcomes in geriatric populations.
Despite growing interest in frailty assessment, its added value when combined with established hip fracture risk scores remains uncertain. In particular, there is limited prospective evidence examining whether frailty assessment improves mortality prediction beyond existing tools such as the NHFS.
This prospective observational cohort study will collect standardized clinical data from older adults undergoing surgical treatment for proximal femoral fractures. Frailty will be assessed at hospital admission using the Clinical Frailty Scale based on the participant's functional status before the fracture. The Nottingham Hip Fracture Score will be calculated from routinely recorded clinical variables.
The analysis will examine the relationship between NHFS, frailty status, and short-term mortality following surgery. Predictive models including NHFS alone will be compared with models that incorporate both NHFS and frailty status in order to determine whether frailty provides additional prognostic information.
Understanding whether frailty assessment improves risk prediction may help clinicians identify vulnerable patients earlier and support more individualized perioperative management in older adults with hip fractures.
- Conditions
- Hip Fracture, Proximal Femur Fracture, Frailty
- Being tested
- No Intervention: Observational Cohort
- Keywords
- Hip fracture, Proximal femur fracture, Frailty, Geriatric fracture, Mortality prediction
- Medical subject headings
- Hip Fractures, Proximal Femoral Fractures, Frailty
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
No Intervention: Observational CohortOther
no intervention
| Study group | Role | What they receive |
|---|---|---|
| Hip Fracture Surgery Cohort | Older adults aged 60 years or older who undergo surgical treatment for proximal femoral fractures. Frailty will be assessed using the Clinical Frailty Scale and mortality outcomes will be evaluated at 30 and 90 days after surgery. Receives: Other: No Intervention: Observational Cohort |
What is being measured
The primary outcome is the main question the study is designed to answer.
90 Day All Cause Mortality
All cause mortality occurring within 90 days after hip fracture surgery.
Measured: 90 days after surgery
Secondary outcomes (3)
30 Day All Cause Mortality
All cause mortality occurring within 30 days after hip fracture surgery.
Measured: 30 days after surgery
Postoperative complications
Measured: 90 days after surgery
Length of hospital stay
Measured: From hospital admission to hospital discharge (up to 30 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2026
- Study start15 Mar 2026
- Primary completion15 Mar 2027 (estimated)
- Study completion15 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Hip FractureStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 200 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Trakya University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Eşref SELÇUK, Trakya University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07481188
- Sponsor's protocol ID
- TÜTF-GOBAEK 2026/81
- Status last verified
- Mar 2026
- First submitted
- 11 Mar 2026
- Last updated
- 31 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Maxwell MJ, Moran CG, Moppett IK. Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth. 2008 Oct;101(4):511-7. doi: 10.1093/bja/aen236. Epub 2008 Aug 21.
PubMed 18723517Narula S, Lawless A, D'Alessandro P, Jones CW, Yates P, Seymour H. Clinical Frailty Scale is a good predictor of mortality after proximal femur fracture: A cohort study of 30-day and one-year mortality. Bone Jt Open. 2020 Aug 1;1(8):443-449. doi: 10.1302/2633-1462.18.BJO-2020-0089.R1. eCollection 2020 Aug.
PubMed 33215137Kennedy MJ, Penfold RS, Donaldson L, Hall AJ, Davison MJ, MacLullich AMJ, Walmsley P, Clement ND, Clarke JV. The Clinical Frailty Scale is a valid and independent predictor of one-year survival in patients sustaining a hip fracture : scottish Hip Fracture Audit data from 8,092 patients. Bone Jt Open. 2025 Dec 4;6(12):1550-1558. doi: 10.1302/2633-1462.612.BJO-2025-0198.R1.
PubMed 41338245
Study at a glance
From the registry record, last updated by the sponsor on 31 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Incremental Prognostic Value of Frailty Beyond the Nottingham Hip Fracture Score for Predicting 90-Day Mortality After Hip Fracture Surgery: A Prospective Cohort Study
- ClinicalTrials.gov ID
- NCT07481188
- Acronym / sponsor ID
- TÜTF-GOBAEK 2026/81
- Conditions
- Hip Fracture, Proximal Femur Fracture, Frailty
- Keywords
- Hip fracture, Proximal femur fracture, Frailty, Geriatric fracture, Mortality prediction
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Trakya UniversityUniversity, hospital or other
- Study start
- 15 Mar 2026 (actual)
- Primary completion
- 15 Mar 2027 (estimated)
- Study completion
- 15 Mar 2027 (estimated)
- First posted
- 18 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hip fractures are serious injuries that occur mostly in older adults. Many people experience health problems or may die in the months after surgery. Doctors try to identify patients who have a higher risk of poor outcomes as early as possible.
Doctors often use the Nottingham Hip Fracture Score (NHFS) to estimate the risk of death after hip fracture surgery. This score uses information such as age and other health conditions. However, it does not fully reflect how physically vulnerable a person may be.
Another important concept is frailty. Frailty describes how strong or weak a person's overall health and physical reserve are. In this study, frailty will be measured using the Clinical Frailty Scale (CFS). This scale evaluates a person's level of independence and physical function before the fracture.
The purpose of this study is to determine whether measuring frailty can improve the prediction of death after hip fracture surgery.
Older adults with hip fractures who undergo surgery will be invited to participate in the study. Researchers plan to include about 200 participants or all eligible patients enrolled within one year, whichever occurs first. Health information that is already collected during routine hospital care will be recorded. Frailty will be assessed when participants are admitted to the hospital.
Participants will be followed for 30 days and 90 days after surgery to determine survival status. Researchers will review hospital records and may contact participants or their relatives by phone if needed.
The results of this study may help doctors better identify patients at higher risk and improve care planning after hip fracture surgery.
Detailed description
Hip fractures in older adults are associated with substantial morbidity, loss of independence, and high early mortality. Identifying patients at increased risk of poor outcomes is therefore an important part of perioperative care and treatment planning. Several clinical tools have been developed to estimate short-term mortality following hip fracture surgery. Among these, the Nottingham Hip Fracture Score (NHFS) is widely used and has been validated in multiple patient cohorts.
The NHFS is calculated using routinely available clinical variables such as age, comorbid conditions, and laboratory values. Although this score performs reasonably well in predicting short-term mortality, it mainly reflects comorbidity burden and demographic factors. It does not directly measure the patient's physiological reserve or overall vulnerability to stress.
Frailty has gained increasing attention as an important determinant of surgical outcomes in older adults. Frailty represents a state of reduced physiological reserve that limits the ability to recover from acute health events such as trauma or surgery. The Clinical Frailty Scale (CFS) is a practical bedside tool that classifies frailty based on functional status and the level of independence prior to illness or injury. Because it can be applied quickly in routine clinical settings, it has been used in various studies evaluating outcomes in geriatric populations.
Despite growing interest in frailty assessment, its added value when combined with established hip fracture risk scores remains uncertain. In particular, there is limited prospective evidence examining whether frailty assessment improves mortality prediction beyond existing tools such as the NHFS.
This prospective observational cohort study will collect standardized clinical data from older adults undergoing surgical treatment for proximal femoral fractures. Frailty will be assessed at hospital admission using the Clinical Frailty Scale based on the participant's functional status before the fracture. The Nottingham Hip Fracture Score will be calculated from routinely recorded clinical variables.
The analysis will examine the relationship between NHFS, frailty status, and short-term mortality following surgery. Predictive models including NHFS alone will be compared with models that incorporate both NHFS and frailty status in order to determine whether frailty provides additional prognostic information.
Understanding whether frailty assessment improves risk prediction may help clinicians identify vulnerable patients earlier and support more individualized perioperative management in older adults with hip fractures.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Hip Fracture Surgery Cohort | – | Other: No Intervention: Observational CohortOlder adults aged 60 years or older who undergo surgical treatment for proximal femoral fractures. Frailty will be assessed using the Clinical Frailty Scale and mortality outcomes will be evaluated at 30 and 90 days after surgery. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Older adults admitted with proximal femoral fractures who undergo surgical treatment at Trakya University Hospital.
Key inclusion criteria (4 listed)
- Age 60 years or older
- Admission for acute proximal femoral fracture (femoral neck, intertrochanteric, or subtrochanteric fracture)
- Surgical treatment for hip fracture
- Ability to obtain clinical data required for NHFS and frailty assessment
Key exclusion criteria (5 listed)
- Pathological fractures
- Periprosthetic fractures
- Hip fractures resulting from high-energy trauma or polytrauma
- Non-operative treatment
- Second hip fracture occurring in the same patient during the study period
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| No Intervention: Observational Cohortno intervention | Other | Hip Fracture Surgery Cohort |
Primary outcome
90 Day All Cause Mortality
Time frame: 90 days after surgery
All cause mortality occurring within 90 days after hip fracture surgery.
3 secondary outcomes
30 Day All Cause Mortality
Time frame: 30 days after surgery
Postoperative complications
Time frame: 90 days after surgery
Length of hospital stay
Time frame: From hospital admission to hospital discharge (up to 30 days)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Mar 2026.
- Background: PubMed 18723517Maxwell MJ, Moran CG, Moppett IK. Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth. 2008 Oct;101(4):511-7. doi: 10.1093/bja/aen236. Epub 2008 Aug 21.
- Background: PubMed 33215137Narula S, Lawless A, D'Alessandro P, Jones CW, Yates P, Seymour H. Clinical Frailty Scale is a good predictor of mortality after proximal femur fracture: A cohort study of 30-day and one-year mortality. Bone Jt Open. 2020 Aug 1;1(8):443-449. doi: 10.1302/2633-1462.18.BJO-2020-0089.R1. eCollection 2020 Aug.
- Background: PubMed 41338245Kennedy MJ, Penfold RS, Donaldson L, Hall AJ, Davison MJ, MacLullich AMJ, Walmsley P, Clement ND, Clarke JV. The Clinical Frailty Scale is a valid and independent predictor of one-year survival in patients sustaining a hip fracture : scottish Hip Fracture Audit data from 8,092 patients. Bone Jt Open. 2025 Dec 4;6(12):1550-1558. doi: 10.1302/2633-1462.612.BJO-2025-0198.R1.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Hip Fracture and Proximal Femur Fracture, run by Trakya University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 31 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Eşref SELÇUK Asst Prof, MD (+905356319974, trkesref@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
90 Day All Cause Mortality (time frame: 90 days after surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07481188, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Mar 2026.