Abstract
International and national predictions from the late 1990s warned of alarming increases in hip fracture incidence due to an ageing population globally. Our study aimed to describe contemporary, population-based longitudinal trends in outcomes and epidemiology of hip fracture patients in a tertiary referral trauma centre.
A retrospective review was performed of all patients aged 65 years and over with a diagnosis of fractured neck of femur (AO classification 31 group A and B) admitted to the John Hunter Hospital, Newcastle, New South Wales between 1st January 2002 and 30th December 2009. Datawas collated and cross referenced from several databases (Prospective Long Bone Fracture Database, Operating Theatre Database and the Hospital Coding Unit). Mortality data was obtained via linkage with the Cardiac and Stroke Outcomes Unit, Planning and Performance, Division of Population Health. Main outcome measures were 30-day mortality, in-hospital mortality, length of stay.
The JHH admitted (427 ± 20/year, range: 391–455) patients with hip fractures over the 9 year study period. The number of admissions per year increased over the study period (p = 0.002), with no change in the age-standardised incidence (p = 0.1). The average age (83.5 ± 0.2) and average percentage female (73.7%) did not change. There was an overall trend to decreased 30-day mortality from 12.4% in 2002 to 7% in 2009 (p = 0.05). The factors that were associated with increased mortality were age (p < 0.0001), male gender (p = 0.0004), time to operating theatre (p = 0.0428) and length of stay (p < 0.0001).
In accordance with national and international projections on increased incidence of geriatric hip fractures, the incidence of fractured neck of femur in our institution increased from 2002–2009, reflecting our ageing population. 30-day mortality improved and longer length of stay corresponded with increased 30-day mortality.
