Hip Fractures in People Older Than 95 Years: Are Patients Without Age-Associated Illnesses Different?

Patients older than 95 years of age can be categorized according to three morbidity profiles: escapers, delayers, and survivors. The aim of this study was to describe the baseline characteristics, in-hospital outcomes, and cumulative mortality of extremely elderly patients admitted with hip fractures and to examine whether there were differences between patients without age-related illnesses (escapers) and others in the same age group (survivors when age-associated illnesses were diagnosed before the age of 80, delayers when these illnesses appeared after the age of 80).

A retrospective review of clinical and outcome data of all patients older than 95 years of age admitted with hip fractures.

Two hundred patients older than 95 years were admitted with hip fractures between December 2009 and September 2015. Eighty-six per cent of patients had at least one in-hospital complication. In-hospital mortality was 12.5 per cent; cumulative mortality rates at 30 days, 3 months, and 1 year were 20.3, 30.8, and 50.5 per cent, respectively. There were 15 (7.5%) escaper patients. Compared with other patients with age-related illnesses, they took fewer drugs, had lower Charlson scores, a higher Barthel index score, shorter length of hospital stay, less delay in surgery, and more often required discharge to an in-patient rehabilitation facility. No differences in cumulative mortality were noted.

Escaper patients had better baseline characteristics, shorter length of hospital stay, and delay in surgery. Nevertheless, their in-hospital and cumulative mortality rates were similar to those of other patients older than 95 years.