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Risk factors affecting inhospital mortality after hip fracture: retrospective analysis using the Japanese Diagnosis
Naoko Shoda1, Hideo Yasunaga, Hiromasa Horiguchi
1Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Objective:
To identify risk factors for inhospital mortality in patients with hip fractures using the Japanese Diagnosis Procedure Combination (DPC) nationwide administrative claims database.
Design:
Retrospective observational study.
Setting:
Hospitals adopting the DPC system during 2007-2009.
Participants:
The authors analysed a total of 80 800 eligible patients aged ≥60 years with a single hip fracture (International Classification of Diseases, 10th Revision codes: S72.0 and S72.1). The DPC database includes patients treated between July and December each year.
Main Outcome Measures:
Inhospital mortality after hip fracture.
Results:
The overall inhospital mortality rate after hip fractures was 3.3%. Multivariate analysis indicated that inhospital mortality was significantly associated with male gender (OR 2.12, 95% CI 1.94 to 2.31), advancing age and number of comorbidities. Significantly higher mortality was observed in those treated conservatively (OR 4.25, 95% CI 3.92 to 4.61). Surgical delays of 5 days or more were significantly associated with higher rates of inhospital mortality (OR 1.34, 95% CI 1.20 to 1.50).
Conclusions:
In patients with hip fractures, male gender, advancing age, high number of comorbidities, conservative treatment and the surgical delay of 5 days or more were associated with higher rates of inhospital mortality.
