One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

Abstract

BackgroundThe purpose of this registry-based retrospective study was to investigate the risk factors related to one-year mortality in displaced intracapsular fragility hip fracture patients.MethodsPatients were screened from the Fragility Fracture Registry. Inclusion criterion was displaced intracapsular hip fracture patients with atypical or pathological fractures excluded. One-year mortality was investigated against risk factors including age, gender, past medical history, pre-fracture mobility (PFM), pre-operation ASA grade, delayed surgery over 48 h, post-surgical complications, and length of stay at acute orthopedic ward (LOS).ResultsA total of 1050 patients were included for further analysis. Gross one-year mortality was 14.9%. One-year mortality was significantly higher in patients who received non-operative treatment and those who received surgery but delayed over 48 h after admission (both p < 0.001). Male gender (OR = 2.708), advanced age (OR = 1.359), higher risk ASA grades (III to V) (OR = 1.990), past history of gastrointestinal disease (OR = 1.671), and renal impairment (OR = 1.984) were related to higher one-year mortality. The mortality of patients in PFM grade 3 and LOS group 3 was significantly higher (OR = 2.240 and 1.722, respectively).ConclusionsHigher age, male gender, past gastrointestinal disease and renal impairment, ASA grade over 3, indoor confined pre-fracture ambulatory, and stay at hospital over 15 days were risk factors related to higher one-year mortality in surgically treated displaced intracapsular hip fracture patients. A multi-disciplinary approach is advised to patients identified with these risks factors and co-managed by orthopedic surgeons, geriatricians, and fracture liaison nurses.

Changing trends in the mortality rate at 1-year post hip fracture - a systematic review

“…Although the literature review included studies within the last 5 years, it is worth noting that the vast majority (83%) of the local studies (30/36) were published within the last 3 years (2015-2017). It is also worth noting that the most recent papers on this topic (published in 2018) confirm that the changing trend in 1-year mortality continues to be observed[ 61 - 63 ]. Cancio et al[ 64 ] this year published a 1-year mortality rate of 22% for a large hip fracture cohort ( n = 30552), which is similar to our findings described above.…”

Fragility Fracture Audit

“…There are, however, marked differences across the health care economies in which they function and in how they are organised and financed. Such factors account for considerable differences in their growth and continuity; their differing ascertainment and follow-up rates and the wide variability documented in Other start-ups have been reported in the last decade, most notably Hong Kong [32,33], Malaysia [34] Lebanon [35] and Iran [36,37], but detailed continuing information about their survival and impact is, to our knowledge, not in the public domain. Other countries such as France, Mexico [38] and Japan [15] are in the pilot phase of national hip fracture audit development.…”

Ortopedik cerrahi sonrası erken dönem hastane mortalitesi ve etki eden faktörler

“…Bu süre ilişkisinden dolayı ampütasyon cerrahisi uygulanan hastalarda kronik böbrek sorunlarının mortaliteye etki etmesi beklenilen bir sonuçtur. Yapılan çalışmalarda KBH uzun dönemli kalça femur boyun kırığı cerrahisi sonrasında mortalite'ye etki eden faktörlerden biri olduğu gösterilmiştir 12 .…”