Key predictive factors in functional decline, and five-year mortality in older adults with hip fracture: a...

Hip fractures in older adults constitute a clinical event with significant functional and life-threatening impact. This study aims to analyze the long-term functional evolution and mortality in patients with hip fractures treated by an interdisciplinary unit.

Prospective study including 300 patients admitted for hip fracture, with follow-up of mortality and functional status (Barthel Index, ambulation, Profunction) at short (1month) and long term (1, 2, 3, and 5years). Sociodemographic, clinical and nutritional variables were analyzed, along with complications and mortality during admission and up to 5years after discharge.

The median baseline Barthel Index score was 90points (mild dependency), declining to 70points at 2years and stabilizing at 3 and 5years, representing a 20-point loss compared with baseline. Independent ambulation increased from 4.3% at 2months to 27.5% at 5years, whereas severe dependency (bed- or chair-bound status) rose from 8.7% to 20.2%. Cognitive and nutritional impairment, the presence of delirium, and prior institutionalization were associated with poorer functional outcomes. The baseline Barthel Index score was a significant predictor of mortality.

A comprehensive and multidimensional assessment could improve the management of patients with hip fracture, allowing the identification of risk factors for poor functional outcomes, such as cognitive impairment, social risk, malnutrition, and delirium.