Introduction The 2002 NCEPOD report recommended that autopsies should be the subject of a formal external audit process. It is thought that a post mortem would improve the understanding of the pathological events leading up to the death of a patient. The aims of this study were to find out the number of post mortems requested for patients with hip fracture and to establish the cause of death of all hip fracture patients as documented on the death certificate by medical practitioners and the coroner.

Patients and Methods A retrospective review of all hip fracture deaths in the year 2000 was performed. The number of cases referred to the coroner for a post mortem and the given verdict was documented. Data regarding the cause of death (as per part 1a on the death certificate) recorded by the medical practitioner and the coroner was established.

Results 83 patients with a hip fracture died in hospital in 2000 (mean age 83.6 years, range 58–97 years). There were 30 male and 53 female deaths. 37 patients (44.6%) were referred to the coroner for a post mortem examination. The common causes of death documented by the medical practitioner were: Bronchopneumonia; 27.9%, Congestive cardiac failure; 11.6%, Left ventricular failure; 9.3%, Cerebrovascular accident; 14%, and Carcinomatosis; 4.6%. The common causes of death documented by the coroner were: Bronchopneumonia; 35.1%, Congestive cardiac failure; 16.2%, Left ventricular failure; 10.8%, Cerebrovascular accident; 2.7%, carcinomatosis; 8.1%, and Pulmonary embolism; 8.1%.

Conclusion Approximately 45% of hip fracture deaths are referred to the coroner. Apart from PE, the cause of death documented by medical practitioners and the coroner was no different in terms of frequency and spectrum. Cardiac and respiratory causes account for nearly 2/3 of hospital hip fracture deaths. Resources need to be targeted accordingly in an attempt to improve in hospital morbidity and mortality.