Abstract
Epidemiologic studies project an increase of hip fractures worldwide. They are an important cause of morbidity and mortality in the elderly and represent an increasing burden on a country's health service. The aim of the study was to evaluate the mortality of hip fractures admitted to a regional hospital in Australia and calculate the relative risk ratio of morbidity variables on mortality.
This retrospective review included all patients admitted from 2003 to 2008 to a regional Queensland hospital with a hip fracture. The relative risk ratio for the probability of death was calculated for the following variables: previous mobility (independent, home with help, nursing home), type of treatment (hemiarthroplasty, ORIF, DHS/Nail, total hip arthroplasty, conservative), ASA, comorbidities (dementia, hypertension, cardiac, respiratory, renal, previous hip fractures, diabetes), pre-operative haemoglobin, BUN ratio, length of stay, operative time, anaesthetic time and type (general, spinal) and, gender.
A total of 211 patients (136 female, 75 male) with an average age of 79.1 years were admitted. Seventy-six patients died during the specified interval. The average 30 day mortality was 6.2% and the average time of survival was 318 days. The relative risk of death was above one for the following variables: female gender 1,16; nursing home 1,11; more than 1 comorbidity 1,38; more than 4 comorbidities 1,78; dementia 1,12; diabetes 1,3; hypertension 1,35, previous fractures 1,43; ASA 4 1,5; operating time more than 120 minutes 7,4; length of stay more than 20 days 2,16, BUN ratio>0.1 1,38 and BUN ration<0.04 1,78.
This retrospective project identified a number of variables influencing mortality of hip fractures. These results demonstrate that the relative risk substantially increases with length of surgical time, length of hospital stay in excess of 20 days and more than four associated comorbidities.
