Hip fracture in Pará State, Brazil: officially recorded mortality and comorbidities in the elderly population. Retrospective cohort study

Abstract

OBJECTIVE: To assess factors related to death among the elderly within one year after hip fracture surgery in Pará State, Brazil, Amazon Region. MATERIAL AND METHODS: A retrospective cohort study was performed using data collected from a referral center for orthopedic surgery and death records from the Pará State Health Department. We enrolled patients aged 60 years or older who were hospitalized for fractures in the proximal third of the femur between January 2015 and December 2016 (N = 542). Data were described using absolute and relative frequencies, means, medians, and respective standard deviations, minimum and maximum values. Clinical and sociodemographic factors associated with death up to one year after hip fracture surgery were investigated. We hypothesized that a delay in surgical intervention would correlate with an increased mortality risk. RESULTS: The death rate within one year was 12.2%. Together, the days between fracture and surgery did not have a statistically significant impact on one-year mortality (OR = 1.01; 95% CI: 1.00-1.03), nor did respiratory comorbidities (OR = 3.04; 95% CI: 0.92-10.06). Only age (OR = 1.053; 95% CI: 1.023-1.084) and male sex (OR = 2.11; 95% CI: 1.24-3.60) were statistically significant with higher mortality one year after surgery. CONCLUSION: Age and male sex were identified as factors associated with one-year mortality. Despite the challenges related to transportation and the limited availability of public health care in the Amazon Region, the delay in surgery did not emerge as a determinant of the mortality outcome.