To evaluate one-year mortality rate of hip fractures treated surgically and assess the influence of medical status and ASA grade on this parameter. 212 patients above 65 years (range 65–100, mean 82.7): There were 104 (49.1%) intertrochanteric and 108 (51.9%) femoral neck fractures. A number of surgical procedures, (sliding/compression screw 104 (49.1%), hemiarthroplasty 81 (38.2%), cannulated screws 18 (8.5%) and total hip replacement (4.2%) were used. The one - year mortality rate was obtained from computerised records, case notes and General Practitioners.

One-year mortality rate for the whole group was 28.8% with an exponential increase corresponding to ASA grade. The relationship between ASA grade and mortality for the whole group (P< 0.001), younger age group of 65 – 84 years (P< 0.001), older age group of 85– 100 years (P=0.002), early operation group < 2 days (P=0.001), females (P=0.000), intertrochanteric fractures (P=0.007), femoral neck fractures (P=0.022) and sliding/compression screw (P=0.007) was highly significant. The type of operation per se and time of operation had no predictive value.

Conclusion: Statistically significant mortality is neither dependent on age, nor type of fracture, time of surgery and type of surgery per se, but is essentially a reflection of ASA status.

The extensive dominant influence of ASA grade is a highly significant predictive determinant and final arbiter of surgical risk and mortality in hip fracture.