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Mortality and morbidity after hip fractures
G S Keene1, M J Parker, G A Pryor
1Department of Orthopaedic and Trauma Surgery, Addenbrooke's Hospital, Cambridge.
Insights
Extracapsular proximal femoral fractures are linked to higher one-year mortality and greater morbidity compared to intracapsular fractures. This highlights the persistent burden of these fractures on healthcare services.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Trauma Care
Background:
- Proximal femoral fractures, commonly known as hip fractures, represent a significant health challenge, particularly in an aging population.
- These fractures are associated with substantial mortality and morbidity, impacting patient independence and healthcare resource utilization.
Purpose of the Study:
- To investigate the mortality and morbidity associated with proximal femoral fractures.
- To compare outcomes based on fracture type: intracapsular versus extracapsular.
Main Methods:
- A consecutive prospective study was conducted over 12 months.
- Data were collected from 1000 acute proximal femoral fractures in 972 patients across two British trauma centers.
Main Results:
- One-year mortality was significantly higher in patients with extracapsular fractures (38%) compared to intracapsular fractures (29%; p < 0.01).
- Patients with extracapsular fractures experienced greater morbidity, including reduced mobility and independence.
Conclusions:
- The increasing age of patients with proximal femoral fractures correlates with high, persistent mortality and morbidity rates.
- Extracapsular fractures present a greater challenge, contributing to the ongoing burden on healthcare services despite advancements in care.
Objective:
To study the mortality and morbidity associated with proximal femoral fractures with reference to fracture type (intracapsular and extracapsular).
Design:
Consecutive prospective study with 12 month follow ups.
Setting:
Two British trauma receiving centres.
Patients:
1000 consecutive acute proximal femoral fractures (fractured necks of femur) in 972 patients.
Results:
Significantly higher mortality at one year was seen in patients with extracapsular fractures (188/490; 38%) than in those with intracapsular fractures (147/510; 29%; p < 0.01). Greater morbidity was experienced during the study period by patients with extracapsular fractures, who were less mobile and less independent at the time of their injury.
Conclusions:
The rise in average age of presentation with proximal femoral fracture is associated with a persistently high mortality (33%) and morbidity, greater in patients with an extracapsular fracture. Comparison with other studies, principally from outside Britain, is difficult, but despite advancing standards of care the mortality and morbidity of femoral neck fractures remains high, placing an ever increasing burden on the health service.