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Updated: Dec 30, 2025

Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
Oldest old hip fracture patients: centenarians as the lowest complexity patients
Juan F Blanco1,2, Carmen da Casa3,4, Rodrigo Sánchez de Vega5
1Trauma and Orthopedics, University Hospital of Salamanca, Salamanca, Spain.
Insights
Hip fractures in centenarians are increasingly common. Despite lower complexity, mortality in these oldest patients is strongly linked to age, with survival decreasing as age increases.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Epidemiology
Background:
- Hip fractures significantly increase mortality and decrease quality of life.
- Increasing life expectancy leads to a growing population of very elderly individuals.
Purpose of the Study:
- To characterize hip fracture patients who are centenarians.
- To compare the outcomes of centenarian hip fracture patients with younger cohorts (nonagenarians and octogenarians).
Main Methods:
- Retrospective study of 176 hip fracture patients (48 centenarians, 65 nonagenarians, 63 octogenarians) from 2009-2018.
- 1-year survival follow-up.
- Statistical analysis included Chi-square, Kruskal-Wallis, Kaplan-Meier, and log-rank tests.
Main Results:
- Centenarians exhibited lower Charlson index, cognitive impairment, and daily drug intake.
- No statistically significant differences in in-hospital, 30-day, or 1-year mortality rates were observed between age groups.
- 1-year survival analysis indicated mortality increased with age (p=0.045).
Conclusions:
- Hip fracture incidence is rising among centenarians, who present with lower comorbidity and complexity.
- While short-term mortality rates are comparable, long-term survival in hip fracture patients is directly correlated with advanced age.
Background:
Hip fracture leads to an increase in mortality and deterioration in the quality of life. The increase in life expectancy results in an increase in the number of oldest old patients.
Aims:
To analyze the characteristics of centenarian hip fracture patients and compare them with younger hip fracture patients.
Methods:
Retrospective study, including 176 patients (48 centenarians, 65 nonagenarians and 63 octogenarians) undergoing surgery after hip from 2009 to 2018 and followed for 1-year survival. Qualitative variables were compared by Chi-square test and quantitative variables, by Kruskal-Wallis test. Survival analysis was performed by Kaplan-Meier test and statistical differences were assessed by log-rank test. p value < 0.05 was considered statistically significant.
Results:
Centenarians showed the lowest Charlson index (p = 0.001), cognitive impairment (p < 0.001), and daily drug intake (p = 0.034). The in-hospital, 30-day and 1-year mortality rates did not show statistical significant differences. The 1-year survival analysis showed that patients died in order of age (p = 0.045). No differences were found regarding readmissions.
Discussion:
Hip fracture incidence in centenarians is increasing. Our study states the lowest complexity for centenarians. Hip fracture mortality rates have been linked to patients' age. In-hospital mortality rate has been reduced, and for the 30-day and 1-year mortality rates, we noted that mortality follows a pattern clearly related to age.
Conclusions:
Centenarians showed the lowest comorbidity and complexity. Readmissions before 1 year, mortality rates at discharge, 30-day and 1-year follow-up were not significantly different, but 1-year survival analysis showed that patients are dying as they are ageing.
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