Abstract
Introduction and purpose: Osteoporotic hip fractures are a major cause of hospital morbidity and mortality in geriatric patients. Our purpose was to study hospital mortality due to osteoporotic hip fractures in persons over 50 in our hospital and evaluate the prognostic factors for mortality.
Materials and methods: We carried out a prospective evaluation of all patients with osteoporotic hip fractures admitted to our hospital between March and September 2004. We emphasised the possible predictive factors for hospital mortality, such as individual background, clinical situation, cognitive aspects, functional and social situation, treatment used and complications. We excluded patients with high-energy or pathological fractures and those who did not want to sign the informed consent form for inclusion in the study. The data were analysed with SPSS statistical software v11.0.
Results: In the six-month period mentioned above, 357 patients were admitted for osteoporotic hip fracture. The female/male ratio was 2.9:1. 37.6% were over 85 and 28.1% had been institutionalised prior to admission. 27 patients died while in hospital (7.6%), with a similar distribution between preoperative and postoperative mortality. The most common causes of death were related to decompensation of the patient’s baseline pathology, mainly of cardiorespiratory origin. Multivariate analysis showed significant prognostic factors independent of hospital mortality (p< 0.05): male sex (RR=4.3), age over 80 (RR=2.9), prior institutionalisation in a care home, the presence of confusional syndrome, low haemoglobin on admission and anaesthetic risk above III.
Conclusions: Hospital mortality was found to be high in cases of hip fracture. This was similar to previous studies carried out in our hospital and others. The prognostic factors for mortality were, above all, those that could not be changed (age, sex, anaesthetic risk, institutionalisation). Patients over 85, men, those coming from a care home and those with high anaesthetic risk have a greater risk of dying while in hospital. We should also be attentive to haemoglobin on admission and the presence of acute confusional syndrome.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain
