The aims of this study were to identify the early
in-hospital mortality rate after hip fracture, identify factors associated
with this mortality, and identify the cause of death in these patients.
A retrospective cohort study was performed on 4426 patients admitted
to our institution between the 1 January 2006 and 31 December 2013
with a hip fracture (1128 male (26%), mean age 82.0 years (60 to
105)). Admissions increased annually, but despite this 30-day mortality
decreased from 12.1% to 6.5%; 77% of these were in-hospital deaths.
Male gender (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.3
to 3.0), increasing age (age ≥ 91; OR 4.1, 95% CI 1.4 to 12.2) and
comorbidity (American Society of Anesthesiologists grades 3 to 5;
OR 4.2, 95% CI 2.0 to 8.7) were independently and significantly
associated with increased odds of in-hospital mortality. From 220
post-mortem reports, the most common causes of death were respiratory
infections (35%), ischaemic heart disease (21%), and cardiac failure
(13%). A sub-group of hip fracture patients at highest risk of early
death can be identified with these risk factors, and the knowledge
of the causes of death can be used to inform service improvements
and the development of a more didactic care pathway, so that multidisciplinary
intervention can be focused for this sub-group in order to improve
their outcome. Cite this article:
