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Hip fracture mortality and morbidity--can we do better?
C W Davidson1, M J Merrilees, T J Wilkinson
1Christchurch School of Medicine, Princess Margaret Hosital.
The New Zealand Medical Journal
|September 8, 2001
Summary
Hip fractures result in high mortality, particularly in men, and significant morbidity, including pain and reduced mobility. Osteoporosis management is often inadequate, with frequent vitamin D deficiency noted in patients.
Area of Science:
- Orthopedics
- Gerontology
- Public Health
Background:
- Hip fractures represent a significant cause of mortality and morbidity in the elderly.
- Effective management and prevention strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To assess mortality and morbidity associated with neck of femur fractures.
- To evaluate the investigation and treatment of osteoporosis in hip fracture patients.
Main Methods:
- Retrospective review of 331 hip fractures (May 1998-April 1999) at Christchurch Hospitals.
- Radiographic classification, mortality data collection, and 12-24 month functional outcome assessment via patient contact.
- Recording of bone density scans, osteoporosis treatment, and vitamin D levels.
Main Results:
- Twelve-month mortality was 26%, with higher rates in men, independent of age.
- Among survivors, 27% reported persistent pain and 60% experienced worsened mobility.
- Vitamin D levels were measured in 15% of patients, with 69% found to be deficient.
Conclusions:
- High mortality and morbidity underscore the need for improved hip fracture prevention.
- Current osteoporosis management is suboptimal, with limited use of therapies beyond calcium.
- Vitamin D deficiency is prevalent and under-recognized in this patient population.
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