Mortality-Related Risk Factors in Geriatric Patients with Hip Fracture

Abstract

Background Mortality rates after hip fractures increase by up to 30% with age. This study investigated the contribution of various parameters to prognosis and mortality. Methods Our study prospectively examined patients with hip fracture aged 65 years and over who applied to the Atatürk University Medical Faculty Hospital Orthopedics Service in 2020–2021. Results The 120 patients included in the study had a mean age of 79.71±7.27 years, and 51.7% were female. Twenty patients (16.7%) died within the first 30 days after a hip fracture. They had a significantly lower median Lawton–Brody instrumental activities of daily living (IADL) scale score (p=0.045) and a higher rate of malnutrition according to the Mini Nutritional Assessment (MNA) score (p=0.016). Additionally, these patients with 30-day mortality had a significantly lower rate of surgical treatment (p=0.027) and a longer time from injury to surgery (p=0.014). The time to surgery was a significant independent risk factor for 30-day mortality, with each 1-hour delay increasing the odds of mortality by 1.066 (odds ratio [OR]=1.066; 95% confidence interval [CI], 1.001–1.013; p=0.013). In addition, the presence of malnutrition was another independent risk factor that increased the odds of mortality by 4.166 times (OR=4.166; 95% CI, 1.285–13.427; p=0.017). Conclusion We recommend placing more importance on supportive treatment in patients presenting with hip fractures, especially in those with malnutrition; performing surgical intervention as early as possible; and more closely following up with patients with the aforementioned risk factors.

Keywords

• geriatrics
• hip fractures
• mortality
• prognosis