The hip is one of the most common fracture sites in people, with hip fractures most frequently occurring in elderly patients, representing an extremely serious outcome of osteoporosis.
In younger patients, hip fractures typically occur as a result of high impact injuries, such as those associated with a traffic accident. Patients with osteoporosis, however, have weakened bones, and can often develop hip fractures from even relatively minor trauma.
Fractures in this region represent the most common type that requires patient hospitalization, since treatment typically requires surgical correction. Approximately 10% of these fracture patients die during hospitalization, however, and it is not exactly clear what risk factors contribute to this excess mortality.
Risk factors for in-hospital post-hip fracture mortality
A recent Australian study evaluated hip fracture patients admitted to a teaching hospital from 1997-2007. They aimed to not only examine risk factors for mortality in these patients, but also to develop a prognostic model to predict in-hospital mortality.
The group evaluated outcomes among 1094 women and 410 men who were admitted to the hospital with a hip fracture.
The median duration of hospitalization was 9 days, and the primary outcome of the study was that in-hospital mortality occurred regardless of length of hospital stay. During hospitalization, the risk of mortality was higher in men (9%) than in women (4%). Increased risk of in-hospital mortality was associated with advancing age in men, as well as the presence of co-morbid conditions on admission. In particular, the risk of mortality was increased in patients with a pre-existing congestive heart failure and liver disease – factors that together accounted for 69% of the risk for in-hospital mortality.
Overall, the results of this study of hip fracture patients determined that increased age, male gender, and pre-existing conditions such as congestive heart failure and liver disease were the main risk factors for mortality during hospitalization. They were, however, unable to develop a prognostic model to predict the outcome of hospitalization following a hip fracture.
Frost SA et al: Risk factors for in-hospital post-hip fracture mortality. (2011) Bone, Jun 13 [Epub ahead of print]