Change in 1-year mortality after hip fracture surgery over the last decade in a European population

Abstract

Objective There are scarce data on the mortality after hip fracture surgery for patients treated in the most recent years. The objective of this study was to analyze whether the overall initiatives introduced over the last decade for elderly patients with hip fractures had a positive impact on the 1-year mortality. Methods Patients treated during 2010–2012 were compared with patients treated during 2018–2020 for all-cause 1-year mortality. Variables influencing mortality were collected based on the literature, including demographic, comorbidity, cognitive status, and preinjury physical function. Crude mortalities were compared between periods, as well as with the expected mortality in the general population adjusted for age, gender, and year of surgery using the standardized mortality ratio (SMR). A multivariate model was used to identify mortality risk factors. Results 591 patients older than 65 years were treated during 2010–2012 and 642 patients during 2018–2020. The mean age increased significantly between periods (78.9 vs. 82.6 years, respectively, p = 0.001) in both genders, together with an increase in comorbidity (p = 0.014). The in-hospital mortality risk had no significant difference between periods (2.5 vs. 2.0%, p = 0.339), but the 30-day mortality risk (8.3 vs. 5.5%, p = 0.031) and 1-year mortality risk (16.1 vs. 11.9%, p = 0.023) declined significantly. However, 1-year mortality in 2020 had an excess of 1.33 in SMR. Age older than 80 years, male gender, and Charlson comorbidity index > 2 were significant predictors of 1-year mortality. Conclusion The important evolution achieved in the last decade for the management of patients with hip fracture surgery has led to a significant decline in 1-year mortality, but the 1-year mortality remains significantly higher compared to the general population of similar age and gender.

RETRACTED: Admission on weekends does not increase mortality after hip fracture: a meta-analysis of 1.4 million patients

“…It cannot be refuted that mortality post-hip fracture is confounded by several variables which include age, gender, comorbidities, pre-injury functional status, cognitive status, type of fracture, delay in surgery, etc. 33,34 Therefore, examining only crude rates without adjusting for basic confounders like age, gender, and comorbidities would generate skewed results and may not be reliable. In this context, the current review of 14 studies with 1.4 million participants was conducted after a thorough literature search to generate the most updated evidence on the topic.…”

Secondary osteoporosis prevention: three-year outcomes from a Fracture Liaison Service in elderly hip fracture patients

“…Moreover, our three-years mortality rate (i.e., 40%) is very similar to another report performed in Turkey in which, authors recommend a multidisciplinary approach to hip fracture patients due its associated comorbidities [ 21 ]. The significant reduction of the adjusted one-year mortality rate may be explained by the improvement in the care for these patients in the public health system which may has led to a significant decline in one-year mortality in the last decade [ 22 ]. Interestingly, a study performed in Italy between 2000 and 2015 showed an increase in the age, institutionalization and comorbidities of hip fracture patients.…”

Preoperative inflammatory biomarkers reveal renal involvement in postsurgical mortality in hip fracture patients: an exploratory study

“…According to the World Health Organization (WHO) hip fractures permanently disable 50% of sufferers and have a 1-year post-fracture mortality around 24% ( 2 – 4 ). The mortality rate after a hip surgery is significantly higher compared to the age and gender-matched population ( 5 ). Post-surgical mortality globally has remained mostly static over the past decade despite comprehensive best-practice surgery and rehabilitation packages ( 6 – 9 ).…”