[Prognostic factors for mortality in elderly patients with hip fracture]

Abstract

Background and objective: The objective of the study was to describe the population of patients undergoing surgery for hip fracture, to assess the incidence of mortality and identify associated prognostic factors, and to evaluate functionality at one year after surgery.

Patients and methods: A retrospective cohort study, with follow-up during the first year after hospital discharge, of patients over 64 years old undergoing surgery for non-traumatic hip fracture during 2008. Variables studied were sociodemographic parameters, clinical complications, functionality and mortality.

Results: A total of 240 patients were included, with a mean age of 83.8 years (SD 7.3), of whom 75.8% were women, 51.7% were ASA III-IV and 28.3% had a Charlson index greater than 2. Surgical delay was greater than 48 h in 61.7% of patients, and the mean hospital stay was 19.6 days (SD 15.9). Over three-quarters (76.3%) of the patients had some postoperative complications, the most frequent being cardiovascular and the cognitive disorders. At one year from surgery, 38.4% were able to walk on their own. In hospital mortality was 7.9%, and was 16.7, 20.4 and 24.6% at 3, 6 and 12 months, respectively. Independent prognostic factors of mortality at one year after surgery were: age, ASA score, Charlson index and post-operative cardiovascular and renal complications.

Conclusions: Hip fracture is associated with a high post-operative morbidity and mortality rate with important limitations in gait and functional status at one year after surgery.