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Predicting mortality following hip fracture: an analysis of comorbidities and complications

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Hip fracture is common in the geriatric population. These patients have multiple comorbidities that complicate treatment and recovery such that poor functional outcomes often result. Since functional outcomes are associated with comorbidities and complications it is important to define the contributing factors.

Aims

To describe comorbidities common to geriatric hip fracture patients and determine predictability of complications and mortality based on comorbidities.

Methods

Data in this study were sourced from information prospectively collected for evaluation of a new orthogeriatric service established at a University Teaching Hospital over the period of 1 year.

Results

The median age was 82 years (range 54–100) and 73 % were female (N = 206). Common comorbidities included hypertension (51 %), dementia (28 %), osteoporosis (19 %), ischaemic heart disease (IHD) (15 %) and chronic obstructive pulmonary disease (15 %). In predicting 1-year mortality based on comorbidities, the final model included age, IHD, delay to surgery and explained 26 % of the variability in mortality. Predicting 1-year mortality based on complications, the final model included age and respiratory complications and explained 26 % of the variability in mortality. There was a significant association between having respiratory complications and chronic obstructive pulmonary disease (p < 0.001) with 63 % of those with respiratory complications having chronic obstructive pulmonary disease.

Conclusions

This study highlights specific patient comorbidities and medical complications that could be used to guide clinical assessment, management and targeted interventions that improve outcomes in this patient group.

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Acknowledgments

We would like to thank Dr. Ailish Hannigan (Associate Professor of Biomedical Statistics at Graduate Entry Medical School University of Limerick) for her statistical advice and support. Author CY Henderson would like to acknowledge the summer student scholarship from Merck Sharpe and Dohme.

Conflict of interest

There are no conflicts of interest.

Ethical standards

Prior to the commencement of the study local ethical approval was received from the University Hospital Limerick’s Research Ethics Committee; this study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Data for this study was collected as an audit and no identifying patient factors were included.

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Authors and Affiliations

  1. Graduate Entry Medical School, University of Limerick, Limerick, Ireland

    C. Y. Henderson

  2. Division of Geriatrics, Department of Medicine, University Hospital Limerick, Dooradoyle, Limerick, Ireland

    J. P. Ryan

Authors
  1. C. Y. Henderson
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  2. J. P. Ryan
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Correspondence to J. P. Ryan.

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Henderson, C.Y., Ryan, J.P. Predicting mortality following hip fracture: an analysis of comorbidities and complications. Ir J Med Sci 184, 667–671 (2015). https://doi.org/10.1007/s11845-015-1271-z

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  • DOI: https://doi.org/10.1007/s11845-015-1271-z

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