One-year mortality in displaced intracapsular hip fractures and associated risk: A report of Chinese-based fragility fracture registry

Abstract

Background: The purpose of this registry-based retrospective study was to investigate the risk factors related to one-year mortality in displaced intracapsular fragility hip fracture patients. Methods: Patients were screened from the Fragility Fracture Registry. Inclusion criterion was displaced intracapsular hip fracture patients with atypical or pathological fractures excluded. One-year mortality was investigated against risk factors including age, gender, past medical history, pre-fracture mobility (PFM), pre-operation ASA grade, delayed surgery over 48h, post-surgical complications, and length of stay at acute orthopedic ward (LOS). Results: A total of 1050 patients were included for further analysis. Gross one-year mortality was 14.9%. One-year mortality was significantly higher in patients who received non-operative treatment and those who received surgery but delayed over 48h after admission (both p< 0.001). Male gender (OR=2.708), advanced age (OR=1.359), higher risk ASA grades (III to V) (OR=1.990), past history of gastrointestinal disease (OR=1.671), and renal impairment (OR=1.984) were related to higher one-year mortality. The mortality of patients in PFM grade 3 and LOS group 3 was significantly higher (OR=2.240 and 1.722, respectively). Conclusions: Higher age, male gender, past gastrointestinal disease and renal impairment, ASA grade over 3, indoor confined pre-fracture ambulatory, and stay at hospital over 15days were risk factors related to higher one-year mortality in surgically treated displaced intracapsular hip fracture patients. A multi-disciplinary approach is advised to patients identified with these risks factors and co-managed by orthopedic surgeons, geriatricians, and fracture liaison nurses.