Long-term mortality in the elderly with hip fracture and its related risk factors

Abstract

Objective To observe the long-term mortality in the elderly patients with hip fracture and evaluate its associated risk factors. Methods Included in this retrospective analysis were the eligible patients who had been treated for hip fracture at Department of Orthopedics, General Army Hospital of PLA from January 2012 to December 2013. Their clinic data were documented, including age, gender, coexisting disease, American Society of Anesthesiologists (ASA) rating, fracture type, operation time and operation pattern. The patients included were divided into 2 groups depending on whether they died or survived during the follow-up period. Mortality-related risk factors included age, gender, comorbidities, timing of operation, and type of fixation. T-test and Chi-squared test were used to analyze any significant differences between mortality and survival. Only the variables with a P<0.05 at the simple regression test were retested into a logistic multiple regression to screen risk factors for mortality after operation. Results Included in this study were 327 eligible patients with an average age of 78.7 years. They were 115 men (35.2%) and 212 women (64.8%). The total mortality till December 2017 was 40.1% (there were 131 dead and 196 living cases). One-way analysis of variance showed that the risk factor related to mortality were stroke (P=0.016), dementia (P=0.005), heart failure (P=0.002), dysfunction of kidney (P=0.027) and type of anesthesia (P=0.015); logistic multiple regression analysis revealed that age (OR=1.092, P=0.000), stroke (OR=1.759, P=0.036), type of anesthesia (OR=6.730, P=0.035) and dysfunction of kidney (OR=5.624, P=0.026) were independent risk factors for long-term mortality. Conclusions Special attention should be paid on hip fracture patients with a high age, stroke and dysfunction of kidney, because their long-term mortality is high. For high risk patients with no obvious contraindications, proper anesthesia methods should be chosen which can lead to definite efficacy and little influence on the body. Key words: Hip fractures; Aged; Risk factors; Mortality