Preoperative Comorbidities Associated With Early Mortality in Hip Fracture Patients: A Multicenter Study

Area of Science:

• Geriatric Medicine
• Trauma Surgery
• Orthopedics

Background:

• Hip fractures in geriatric patients are linked to increased mortality and complications.
• Understanding specific patient factors and comorbidities is crucial for improving outcomes.

Purpose of the Study:

• To characterize the relationship between patient factors, comorbidities, and outcomes in geriatric hip fracture patients.
• To identify specific comorbidities associated with mortality, complications, and length of stay.

Main Methods:

• Retrospective review of a trauma database from five trauma centers.
• Inclusion of patients with femoral neck and intertrochanteric hip fractures.
• Analysis of mortality (in-hospital, 30, 60, 90-day), adverse events, ICU transfer, length of stay, and discharge disposition using regression analyses.

Main Results:

• Mortality rates were 1.8% (in-hospital), 7.0% (30-day), 10.9% (60-day), and 14.1% (90-day).
• Diabetes and cognitive impairment were associated with mortality at all intervals.
• COPD was linked to in-hospital adverse events (OR 1.67) and longer hospital stays, as was renal failure.

Conclusions:

• Geriatric hip fractures exhibit significant short-term morbidity and mortality.
• Early identification of high-risk patients (diabetes, cognitive impairment, renal failure, COPD) can guide optimized perioperative care.
• Multidisciplinary management, including medicine teams, may improve outcomes without delaying surgery.