Mortality following surgery for proximal femoral fractures in centenarians

Although the number of centenarians in our population is increasing, mortality rates following hip fracture in this group of patients has not yet been reported. The medical records of a consecutive series of 13 centenarians with proximal femoral fractures who presented to the Derbyshire Royal Infirmary over a 20 year period were retrospectively reviewed. The majority of patients were female (M:F 2:11) and had suffered intertrochanteric fractures. The recorded incidence of surgical complications was low. The mortality at 30 days, 6 months and 1 year were 31%, 50% and 56%, respectively representing a 20% increase in mortality at 1 year when compared to the expected mortality rates among their non-injured peers. When compared with over 1000 hip fracture patients of all ages in previous prospective studies, the centenarians in this series were found to have a significantly higher mortality during hospital admission (p<0.001) and at 1 year (p=0.002). The treatment of hip fractures in centenarians poses a challenge. Optimal anaesthesia, expeditious surgery and a co-ordinated multidisciplinary approach to care is essential in these patients.