Comorbidity as a predictor of mortality and mobility after hip fracture

To determine mortality and mobility rates after hip fracture.

A prospective study (n = 199 patients) was carried out in the Health Care Center of A Coruña (Spain) during the period between January 2009 and December 2011. A descriptive study, and Cox and logistic regression analysis were carried out. Informed consent and ethical review board approval were obtained (code 2010/120 CEIC Galicia).

The patients' mean age was 82.5 ± 8.4 years and 76% were female. The average Charlson Comorbidity Index score was 6.1 ± 2.1. Creatinine clearance <60 mL/min/1.73 m(2) was 44%. The probability of survival 6 months after hip fracture was 89.2% and the survival rate at 12 months was 81.4%. Cox regression analysis showed that the indicator that most influenced mortality rate was comorbidity (HR = 1.133; P = 0.020) and age approaching borderline statistical significance (HR = 1.034; P = 0.064). The Parker Mobility Score decreased significantly (P < 0.001) after hip fracture. Before fracture, 19% of the patients were able to get about the house, 26% were able to get out of the house and 55% were able to go shopping. After hip fracture (90 days), the percentages changed to 56.2%, 19.1% and 24.7%, respectively (P < 0.001). After taking into account age, sex, type of fracture, surgical delay, previous fracture and comorbidity, the only indicator capable of predicting incapacity to walk was comorbidity.

Comorbidity is the best predictor of mortality and mobility after hip fracture. Geriatr Gerontol Int 2016; 16: 561-569.