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Hip fractures in the elderly: predictors of one year mortality
G B Aharonoff1, K J Koval, M L Skovron
1Department of Orthopaedic Surgery, Hospital for Joint diseases, New York, NY 10003, USA.
Objective:
To determine the one year mortality following hip fracture in an ambulatory, community dwelling, cognitively intact elderly population and to examine the role of specific type, number, and severity of associated medical comorbidities.
Design:
Prospective, consecutive.
Methods:
Six hundred twelve elderly who sustained a non-pathologic hip fracture were followed.
Results:
Twenty-four patients (4%) died during hospitalization; seventy-eight (12.7%) died within one year of fracture. The factors that were predictive of mortality, based on multivariate analysis, were patient age > 85 years, preinjury dependency in basic activities of daily living, a history of malignancy other than skin cancer, American Society of Anesthesiologists rating of operative risk 3 or 4, and the development of one or more in-hospital postoperative complications; all factors other than the development of an in-hospital complication were independent of treatment.
Conclusion:
These results indicate that efforts at reducing one year mortality after hip fracture should be directed at the prevention of postoperative complications.