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1 year mortality after hip fracture in an Irish urban trauma centre
Helena Ferris1, Georgia Merron2, Tara Coughlan3
1Department of Public Health, Health Service Executive - South, Cork, Ireland. ferrish@tcd.ie.
Insights
Early postoperative mobilization significantly improves survival rates for hip fracture patients in Ireland. This modifiable factor is key to optimizing care pathways and enhancing patient outcomes following hip fracture surgery.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Public Health
Background:
- Hip fractures pose a significant health burden on older adults.
- Limited data exists on long-term outcomes for Irish hip fracture patients.
- Current Irish systems lack national death registration linkage and long-term outcome tracking for hip fractures.
Purpose of the Study:
- To determine the 1-year mortality rate in an Irish hip fracture cohort.
- To identify factors influencing survival at 1 year post-hip fracture.
- To inform the refinement of care pathways for hip fracture patients.
Main Methods:
- Retrospective analysis of hip fracture cases from an Irish urban trauma center over 5 years.
- Mortality data obtained through the Inpatient Management System and Irish Death Events Register.
- Logistic regression analysis of patient and care process variables.
Main Results:
- 1-year mortality rate was 20.5% (171/833) in the cohort.
- Factors reducing 1-year mortality included female gender, pre-fracture independent mobility, and early postoperative mobilization.
- Early mobilization on the day of or after surgery significantly reduced mortality risk (OR 0.48).
Conclusions:
- Early postoperative mobilization is the sole identified modifiable factor improving longer-term survival after hip fracture.
- Adherence to international best practice standards for early mobilization is crucial.
- Findings highlight the importance of early mobilization in optimizing hip fracture patient outcomes.
Background:
Hip fracture accounts for a considerable burden of disease in older adults, yet there is a paucity of data pertaining to longer-term outcomes in the Irish Hip Fracture population. Understanding the factors that influence longer-term survival would allow care pathways to be refined to optimise patient outcomes. In Ireland, there is no linkage to death registration at a national or regional level, nor are longer-term outcomes captured by the Irish Hip Fracture Database. This study aimed to quantify 1-year mortality in an Irish hip fracture cohort and identify factors that influence survival at 1 year.
Methods:
A retrospective review of hip fracture cases in an Irish urban trauma centre over a 5-year period was conducted. Mortality status was obtained via the Inpatient Management System and correlated with the Irish Death Events Register. A range of routinely collected patient and care process variables were analysed using logistic regression.
Results:
A total of 833 patients were included. Within 1 year of sustaining a hip fracture, 20.5% (171/833) had died. On multivariate analysis, female gender (OR 0.36, p < 0.001, 95% CI 0.23-0.57), independent mobility pre-fracture (OR 0.24, p < 0.001, 95% CI 0.14-0.41) and early mobilisation on the day of or after surgery (OR 0.48, p < 0.001, 95% CI 0.30-0.77) reduced the likelihood of dying within 1 year (AUC 0.78).
Conclusion:
Of the variables examined, early postoperative mobilisation was the only modifiable factor identified that conferred a longer-term survival benefit. This underscores the importance of adhering to international best practice standards for early postoperative mobilisation.
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