All-cause mortality rates in nonagenarians treated for hip fracture

To identify in-hospital, 30-day, and one-year mortality rates in patients aged 90 and above who underwent hip fracture surgery at an Irish tertiary referral hospital.

The authors retrospectively examined two years of theatre lists from 2021 to 2023. Inclusion criteria were an age of 90 and above at the time of fracture and surgical treatment of a proximal femur fracture. Exclusion criteria were periprosthetic fractures and patients who had conservative management. Mortality rates were extracted from hospital records and a national online death notices website.

We identified 69 patients aged greater than 90 years old who received surgical management of a hip fracture between November 2021 and November 2023. Among these 69 patients, in-hospital mortality was 6 (8.7%), 30-day mortality was also 6 (8.7%), and one-year mortality was 23 (33%).

The one-year mortality rate among a sample of nonagenarians managed surgically for hip fracture at a single Irish hospital is higher than the estimated all-age one-year mortality rate, demonstrating significant long-term mortality in the eldest patients. No "90 paradox" was observed in mortality rates.