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SANDRA RITCHIE, MD, JEEHYUN HELEN BAE, MD, AND JON O. NEHER, MD

Am Fam Physician. 2025;112(6):679-680

 This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

CLINICAL QUESTION

Does use of frailty scoring in older adults help predict hip fracture outcomes?

EVIDENCE-BASED ANSWER

Frailty scoring is recommended for adults older than 70 years hospitalized for hip fracture to aid in shared decision-making with patients and family members. (Strength of Recommendation: B, meta-analyses of cohort trials and subsequent cohort trials.) Hospitalized adults older than 70 years with hip fracture and frailty have an increased risk of mortality and complications, longer hospital stays, and poorer functional status at discharge vs patients without frailty. In patients with frailty, cardiovascular disease, respiratory complications, and multiorgan system failure contribute to excess mortality after hip fracture.

EVIDENCE SUMMARY

A systematic review and meta-analysis of 22 cohort studies investigated the prognostic significance of frailty scoring in 74,837 patients admitted for hip fracture. Studies were conducted in 11 countries, used 15 different frailty scoring tools, and included patients who were mostly older than 70 years. Frailty was defined differently in each of the scoring tools. The prevalence of frailty across the studies ranged from 6.5% to 80.7%.1

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Clinical Inquiries provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (https://www.cebm.net).

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to https://www.fpin.org or email questions@fpin.org.

Copyright © Family Physicians Inquiries Network. Used with permission.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of FPIN’s Clinical Inquiries published in AFP is available at https://www.aafp.org/afp/fpin.

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