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Mortality and Related Risk Factors of Fragile Hip Fracture
Pei-Wen Wang1, Xue-Dong Yao1, Hua-Feng Zhuang1
1Department of Orthopaedic Surgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
Insights
Mortality in fragile hip fracture patients is linked to advanced age, male gender, and lack of surgery or anti-osteoporosis treatment. Prompt intervention and treatment significantly reduce death risks in these vulnerable patients.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Public Health
Background:
- Fragile hip fractures represent a significant health concern in elderly populations, often leading to increased morbidity and mortality.
- Understanding the determinants of mortality is crucial for developing targeted interventions and improving patient outcomes.
Purpose of the Study:
- To investigate the mortality rates associated with fragile hip fractures.
- To identify and analyze the key risk factors contributing to death in this patient cohort.
Main Methods:
- Retrospective analysis of clinical data from 690 patients (age 50-103) with osteoporotic hip fractures treated between 2010 and 2015.
- Assessment of 3-month, 1-year, and total mortality, with statistical comparison of risk factors including age, gender, surgery, time to operation, and comorbidities.
- Binary logistic regression analysis to determine independent risk factors for mortality.
Main Results:
- Overall mortality rates were 7.69% at 3 months, 15.60% at 1 year, and 24.06% by the end of the follow-up period.
- Higher mortality was observed in patients over 75, males, those not receiving surgery, those operated on after 5 days, and those with multiple comorbidities.
- Conversely, receiving anti-osteoporosis treatment was associated with significantly lower mortality.
Conclusions:
- Advanced age (>75 years), male gender, non-surgical treatment, multiple comorbidities (≥2), and lack of anti-osteoporosis treatment are independent risk factors for mortality.
- These factors significantly impact 3-month and 1-year mortality in patients with fragile hip fractures.
- Timely surgical intervention and appropriate management of underlying conditions, including osteoporosis, are critical for improving survival rates.
Objective:
To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors.
Methods:
A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis.
Results:
The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002).
Conclusion:
Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures.
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