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AbstractPurpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, n ¼ 45). Log-rank test revealed that previous fractures (p ¼ 0.003), Barthel index (BI) at discharge (p ¼ 0.011), and place-to-discharge (p ¼ 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p ¼ 0.023), total Charlson comorbidity index (TCCI; p ¼ 0.005), smoking (p ¼ 0.007), length of hospital stay (LOS; p ¼ 0.009), and BI (p ¼ 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p ¼ 0.044), and BI <30 (HR 5.42, p ¼ 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m 2 (HR 2.70, p ¼ 0.023), TCCI 5 (HR 2.61, p ¼ 0.032), smoking history (HR 3.59, p ¼ 0.018), LOS <14 days (HR 13.9; p ¼ 0.007), and BI <30 (HR 2.76; p ¼ 0.049) were the counterparts for females. Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m 2 , TCCI 5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.