Mortality and quality of life after trochanteric hip fracture

The objective was to evaluate the survival and some aspects of the quality of life of patients with trochanteric hip fracture after long-term follow-up in comparison with the age- and sex-matched controls without fracture. Two hundred consecutive patients (mean age at fracture 77 y) with trochanteric hip fractures were compared with the age- and sex-matched controls representing an average population from the same area. After a mean 7 y follow-up period a questionnaire concerning their place of residence, ambulation, causes leading to impairment, need for locomotor aids and management of activities in daily living (ADL) functions was sent to the surviving patients and controls. Mortality increased gradually being 4.5 percent above the control level one month after the fracture, 6.0 percent above at three months, 3.5 percent above at one year, 4.5 percent above at two years, 6.5 percent above at five years and 9.0 percent above at six years. Thirty (48%) of the surviving 62 patients and 83 (90%) of the 92 surviving controls were living in their own homes and 2 (3%) and 4 (4%) in service apartments respectively. Seventeen (27%) of patients alive were institutionalized in a chronic care hospital unit and 13 (21%) in an old people's home as compared with 2 (2%) and 3 (3%) of the controls respectively. Twenty-two (35%) of the patients and 73 (79%) of the controls were able to move about independently. The patients were significantly worse at ADL-management, required more home help and had fewer social contacts and outdoor hobbies than the controls. In conclusion surgically-treated trochanteric hip fractures markedly increase mortality rate, reduce independence and impair walking ability and ADL-functions, and thus seriously affect the health-related quality of life of the patients. This fact should be considered in the planning of the healthcare of elderly people.