Survival analysis of patients with hip fracture, Shiraz, Iran

This study aimed to determine factors affecting the survival of patients with hip fracture in Shiraz, Iran. Alzheimer's disease, hypertension, and cardiovascular diseases were risk factors, while female gender and living with family members or in nursing homes were protective factors against mortality following hip fracture.

Hip fractures are the most common orthopedic fractures in elderly. This study aimed to determine the factors affecting the survival of patients with hip fracture in Shiraz.

This historical cohort study was conducted in Shiraz, Iran. All patients with hip fracture who were admitted to any of the hospitals providing orthopedic services in Shiraz, from September 1, 2011, to August 30, 2012, were included in the study. The log rank test, Kaplan-Meier methods, and the univariate and multivariate Cox regression model were used for data analysis.

A total of 631 patients were enrolled, of these, 264 (41.8%) were male. The mean age of patients was 74.9 ± 11.5. The patients' survival rate after the 1st, 2nd, 3rd, 4th, and 5th year were 81.1%, 73.7%, 69.4%, 64.8%, and 60.2%, respectively. After adjusting data for age, Alzheimer's disease (HR = 4.9, 95% CI 1.4-7.3, P = 0.023), hypertension (HR = 2.27, 95% CI 1.3-3.8, P = 0.003), and cardiovascular diseases (HR = 2.02, 95% CI 1.04-3.09, P = 0.039) remained as risk factors for mortality in patients with hip fracture. However, female patients (HR = 0.46, 95% CI 0.27-0.8, P = 0.006) and those who lived with family members or in nursing homes (HR = 0.43, 95% CI 0.19-0.92, P = 0.03) were protective factors.

This study showed that women are more likely to have hip fractures, but mortality among men is more observable. Alzheimer's disease, hypertension, and cardiovascular diseases were considered as risk factors, while patients who were female and those who lived with the family member or in nursing homes had better survival.