Article Text
Abstract
Objectives Identify risk factors for mortality after hip fracture.
Material and Methods Patients admitted in the orthopaedics service of the main hospital in Porto city, from 1 May 2008 to 30 April 2009, with a low-energy hip fracture were selected. During admission a questionnaire was applied and phone interviews to the patients or a close relative were done at 3, 6, 9 and 12 months after the fracture. From hospital registers, fracture type, surgery date, surgical treatment, co-morbilities and ASA score were obtained.
Results At admission, patients (n=252, 79% women, mean age of 80.3±9.5 years and 76.3±11.3 years (p<0.05), women and men respectively) lived mainly with someone (67%); 1% were confined to bed, 65% had difficulties in walking or doing daily activities and 34% had a life without restrictions. The most common co-morbidities were hypertension for women (52% vs 38%) and respiratory disease for men (36% vs 11%), p<0.05. Death was 22%, 25%, 30% and 37% for men and 8%, 14%, 20% and 23% for women, respectively at 3, 6, 9 and 12 months of follow-up. Death was higher among institutionalised patients. Survival analysis using Kaplan–Meier curve and Cox regression analysis showed that the risk of dead increased 6% for each age-year older, 151% if patient was a man, 94% for ASA score III/IV and 7% for each day of delay to the surgery.
Conclusion Older age, male sex, ASA scores III/IV and delay to surgery are good predictors of mortality after a hip fracture.