Mortality in centenarians with hip fractures

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Public Health

Background:

• Osteoporosis commonly weakens the proximal femur, increasing hip fracture risk.
• The centenarian population (individuals aged 100 years and older) is rapidly growing, leading to more hip fracture cases.
• Limited research exists on the outcomes and mortality rates for hip fractures in centenarians.

Purpose of the Study:

• To evaluate the mortality rates in centenarians who sustained hip fractures.
• To determine the safety and appropriateness of operative intervention for hip fractures in this age group.

Main Methods:

• Retrospective review of 23 patients aged 100 years or older with hip fractures treated between 2003 and 2010.
• Data collected included patient demographics, Charlson comorbidity index, treatment type (operative vs. nonoperative), and mortality dates.
• Mortality rates were calculated at various intervals (in-hospital, 30-day, 90-day, 6-month, 1-year, 2-year, 3-year, and 6-year).

Main Results:

• Twenty-one patients were treated operatively; two were treated nonoperatively.
• Operatively treated patients experienced cumulative mortality rates of 15% (in-hospital), 20% (30-day), 30% (90-day), 45% (6-month), 60% (1-year), 70% (2-year), 90% (3-year), and 95% (6-year).
• Both nonoperatively treated patients died within 90 days. Postoperative complications occurred in 43% of patients.

Conclusions:

• Operative treatment for hip fractures in centenarians is associated with an acceptable mortality rate.
• Age alone should not be a contraindication for surgical intervention in this population.
• Further research is warranted given the increasing number of centenarians sustaining hip fractures.