Predictors of In-Hospital Mortality in Older Adults Undergoing Hip Fracture Surgery: A Case–Control Study

Abstract

Introduction: Although surgery has been proven to improve the long-term survival of older adults with hip fracture, in-hospital mortality directly resulting from repair of hip fracture is undesirable. This study aimed to identify potential prognostic factors that predict in-hospital mortality risk in elderly patients following hip fracture surgery. Materials and Methods: This case–control study comprehensively collected data from older adults with hip fracture admitted to a single medical centre. Age was selected as the cross-matching factor. Univariate and binary multivariate logistic regression models were used to estimate the odds ratios with 95% confidence intervals. A receiver operating characteristic curve was constructed to quantify the discrimination power of the model. Results: Among a total of 841 older adults who received hip fracture surgery, 17 died during hospitalisation, yielding a 2.0% in-hospital mortality rate. Using a binary multivariate logistic regression model to perform a comparison with 51 age-matched patients in survival groups, the model revealed that estimated glomerular filtration rate (eGFR) and malignant cancer history were the only 2 factors significantly correlated with in-hospital mortality. The prognostic values for the eGFR and malignant cancer history were acceptable, with areas under the curve of .76 and .67, respectively. Conclusion: The prevalence of in-hospital mortality following hip fracture is low. After adjustment for age, eGFR and malignant cancer history were identified as factors significantly correlated with in-hospital mortality. The findings of this study could assist in the early screening and detection of patients with high in-hospital mortality risks.

Inverse relation of body weight with short-term and long-term mortality following hip fracture surgery: a meta-analysis

“…Hip fractures are associated with increased mortality in older adults [ 2 ]. Although hip fractures are not a direct cause of death, comorbidities resulting from hip fracture and subsequent immobility play a critical role in the development of thrombosis-related complications [ 29 ].…”

“…Hip fractures, which are associated with high morbidity, mortality, and high health-care costs, are a global challenge [ 1 ]. The reported in-hospital mortality rate for older patients receiving hip fracture surgery was estimated to be approximately 2% [ 2 ], and the 1-year mortality rate following hip fracture surgery ranges from 14 to 18.1% [ 3 ]. In addition, one-third of the older population is reportedly severely dependent at 1 year after hip fracture surgery [ 4 ].…”

Automated osteoporosis classification and T-score prediction using hip radiographs via deep learning algorithm

“… 1 Hip fracture is the most debilitating among all fragility fractures, resulting in chronic pain, loss of independence, 2 decreased quality of life, 3 and high mortality following hip fracture surgery. 4 The classification of osteoporosis is defined by the lowest bone mineral density (BMD) on the axial bone, including spine and bilateral hip regions. 5 However, BMD on the proximal hip area is especially critical to directly reflect the future risk of hip fracture.…”

Early Posttraumatic Antifibrinolysis Reduces Perioperative Hidden Blood Loss in Elderly Patients with an Intertrochanteric Fracture: A Randomized Controlled Trial

“…Most intertrochanteric fractures need surgery for the purpose of avoiding immobility-related complications, walking ability, and diminished quality of life [2]. Despite great progress having been made in surgical techniques and perioperative management [3][4][5][6], perioperative mortality can still reach 0.8-2%, and 30-day and 1-year mortality can even reach 8% and 25%, respectively [7][8][9]. Research demonstrates that anaemia caused by hip fractures and subsequent surgery is an important risk factor for perioperative mortality, especially when Hb levels are below 80 g/L [10].…”