BACKGROUND:Patients with elder hip fracture has more complications, poor affordability and high perioperative risk, so the preoperative ful preparation and evaluation are needed. OBJECTIVE:To predict the accuracy of the prognosis of elderly patients with hip fracture through comparing the difference between American Society of Anesthesiologists score and Daping orthopedics operation risk scoring system for senile patients. METHODS:A retrospective study was performed on 300 cases with elderly hip fracture selected from January 2011 to December 2012 from Department of Orthopedics, Gongli Hospital of Pudong. American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were conducted before treatment, and the predictive values of two scoring systems on the incidence of complications and mortality were compared. RESULTS AND CONCLUSION:According to the American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients, 148 cases and 97 cases had complications respectively. On the contrary, the actual number of complications was 89. The former predicted value was significantly higher than the actual value, and there was no significant difference between the latter forecast value and the actual value. The numbers of death predicted by American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were 27 cases and six cases, but the actual number of death was three cases, indicating that former predicted value was significantly higher than the actual value, and there was no significant difference between the latter predicted value and the actual value. The American Society of Anesthesiology score has a certain errors in predicting the postoperative complications and mortality of patients with elderly hip fractures, but it is simple and useful in clinic. The Daping orthopedics operation risk scoring system for senile patients can accurately evaluate elderly hip fracture operation risk, and can predict the postoperative complications and mortality more objective when compared with the American Society of Anesthesiology score.%背景：老年髋部骨折患者合并症较多，承受能力差，围手术期风险高，因此，需要治疗前进行充分的准备与评估。 目的：比较美国麻醉医师协会评分与大坪骨科老年患者手术风险评分两种方法，预测老年髋部骨折治疗预后准确性的差异。 方法：选取上海市浦东新区公利医院骨科2011年1月至2012年12月收治的老年髋部骨折患者300例，治疗前进行美国麻醉医师协会评分及大坪骨科老年患者手术风险评分，比较两种评分系统对治疗后并发症和病死率的预测价值。 结果与结论：根据美国麻醉医师协会评分、大坪骨科老年患者手术风险评分预测，并发症发生例数分别为148例及97例，而实际发生并发症89例。前者预测值显著高于实际值，后者预测值和实际发生差异无显著性意义。预测死亡例数分别为27例及6例，实际死亡3例，前者预测值明显高于实际值，后者预测值和实际值差异无显著性意义。结果可见美国麻醉医师协会评分预测老年髋部骨折患者治疗后并发症和病死率有一定误差，但评分系统在临床上应用简便。与美国麻醉医师协会评分比较，大坪骨科老年患者手术风险评分能够较为准确地评估老年髋部骨折手术风险，并且能够较为客观的预测治疗后并发症和病死率。
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