Risk factors for in-hospital mortality following hip fracture. / Factores de riesgo de mortalidad intrahospitalaria en la fractura proximal de fémur.

ABSTRACT

OBJECTIVE: To identify and quantify the risk factors for in-hospital mortality in patients older than 65 years with a hip fracture. MATERIALS AND METHODS: Retrospective review of prospectively collected data. We studied a cohort of 331 hip fracture patients older than 65 years of age admitted to our hospital from 2011 to 2014. Patients demographics, type of residence, physical function, mobility, prefracture comorbidities data, cognitive status, anti-aggregant and anticoagulant medication, preoperative haemoglobin value, type of fracture, type of treatment, surgical delay, and complications, were recorded. RESULTS: The average age was 83, 73% female, and 57% had sustained a subcapital fracture. In 62.8% pre-fracture baseline co-morbidities were equal or greater than 2. The in-hospital mortality rate was 11.4%. In univariate analysis, age over 90, male gender, haemoglobin ≤ 10g/dl, no antiplatelet agents, orthopaedic treatment, number of co-morbidities≥2, Charlson index≥2, age-adjusted Charlson index≥6, congestive heart failure, asthma, rheumatologic disease, were associated with in-hospital mortality. CONCLUSIONS: Preoperative patient-related factors have a strong relationship with in-hospital mortality in a hip fracture patients aged older than 65 years. These factors are non-modifiable; we recommend the development of protocols to reduce in-hospital mortality in this group of patients.