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Osteoporotic hip fracture mortality and associated factors in Hawai'i
Kaitlin Hori1, Andrea M Siu2, Edward T Nguyen3
1University of Southern California, Los Angeles, USA.
Insights
Mortality after osteoporotic hip fracture in patients aged 50+ is significant, reaching 30.1% by 3 years. Older age, male sex, and Medicare/Medicaid insurance increase this risk.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Public Health
Background:
- Osteoporotic hip fractures represent a significant health burden in elderly populations.
- High mortality rates are associated with hip fractures, necessitating research into contributing factors.
Purpose of the Study:
- To evaluate mortality rates and identify associated risk factors in patients aged 50 and older who sustained osteoporotic hip fractures.
- To analyze mortality data within a large healthcare system in Hawai'i.
Main Methods:
- Retrospective chart review of 428 patients (≥50 years) hospitalized for osteoporotic hip fractures (Jan 2015 - May 2016).
- Data collection included demographics, comorbidities, and treatment.
- Mortality calculated at 30 days, 90 days, 1, 2, and 3 years post-admission.
- Multivariable logistic and proportional hazards regression analyses were employed.
Main Results:
- 30-day mortality was 4.2%, increasing to 30.1% by 3 years.
- Factors associated with increased mortality included older age (HR=1.06), high comorbidity load (HR=1.30), and Medicare/Medicaid insurance (HR=3.78).
- Female sex (HR=0.54) and higher BMI (HR=0.94) were associated with decreased mortality.
Conclusions:
- Osteoporotic hip fractures in patients aged 50 and older are associated with substantial short- and long-term mortality.
- Key predictors of mortality include advanced age, male sex, comorbidities, insurance status, and body mass index.
- These findings highlight the need for targeted interventions to improve outcomes for this vulnerable patient group.
Abstract:
The 30-day mortality of osteoporotic hip fracture patients ≥ 50 years at Hawai'i Pacific Health (2015-2016) was 4.2%. Mortality increased to 17.1% (1 year), 24.5% (2 years), and 30.1% (3 years). Increased age, male sex, higher CCI score, primary insurance status-Medicare/Medicaid, and lower BMI were associated with increased mortality.
Purpose:
The objective of this study was to evaluate mortality and factors associated with mortality of osteoporotic hip fracture patients at community hospitals within a large healthcare system in Hawai'i.
Methods:
A retrospective chart review was conducted of 428 patients, ≥ 50 years, and hospitalized for a osteoporotic hip fracture from January 2015 to May 2016 within a large healthcare system in Hawai'i. Patient demographics, comorbidities, and treatment were collected from retrospective chart review. We determined the date of death by review of medical records and online public obituary records. We calculated 30-day, 90-day, 1-year, 2-year, and 3-year mortality after discharge for hip fracture admission. Multivariable logistic regression and proportional hazards regression were used to evaluate associations between variables and the mortality of the patients.
Results:
The 30-day and 90-day mortality after admission for hip fracture were 4.2% and 8.6%. One-year mortality, 2-year mortality, and 3-year mortality were 17.1%, 24.5%, and 30.1%, respectively. Through proportional hazards regression, older age (hazard ratio (HR) = 1.06, p < 0.001), high comorbidity load (HR = 1.30, p < 0.001), and primary insurance status-Medicare/Medicaid (HR = 3.78, p = 0.021) were associated with increased mortality, while female sex (HR = 0.54, p < 0.001) and higher BMI (HR = 0.94, p = 0.002) were associated with lower mortality.
Conclusion:
After admission for osteoporotic hip fracture, the 30-day mortality was 4.2%. At 1 year, 2 years, and 3 years, mortality increased to 17.1%, 24.5%, and 30.1%, respectively. Increased age, male sex, higher Charlson comorbidity index score, primary insurance status-Medicare/Medicaid, and lower body mass index were associated with increased mortality.
