Predictive factors for thirty day mortality in geriatric patients with hip fractures: a prospective study

• Published in: International orthopaedics 2019-02, Vol.43 (2), p.275-281
• Main Authors: Forni, Cristiana, Gazineo, Domenica, D’Alessandro, Fabio, Fiorani, Ambra, Morri, Mattia, Sabattini, Tania, Ambrosi, Elisa, Chiari, Paolo
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Orthopedics
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-018-4057-x

Purpose The study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors. Methods A prospective multicentric study was performed. All patients aged ≥ 65 years, with fragility hip fractures, consecutively admitted in two Italian hospitals were included. Patients with periprosthetic or pathological fractures were excluded. Logistic regression was used to identify patient and patient care variables that independently influenced the 30-day mortality and receiver operating characteristic (ROC) curve analysis to assess their predictive capacity on the outcome. Results Of the patients, 728 met the inclusion criteria, of whom approximately 5% died within 30 days after admission. The 45.7% of the deceased patients died while hospitalized. Multivariate analysis showed that advancing age was the only independent predictor of 30-day mortality (OR = 1.084, 95% CI = 1.024–1.147), while a higher presence of informal caregivers was a protective factor (OR = 0.988, 95% CI = 0.979–0.997). The area under the ROC curve of the model was 0.723 (CI95% 0.676–0.770) for 30-day mortality in elderly hip fractures patients. Conclusions Patients with an advanced age need careful follow-up, especially within 30 days following operation for hip fracture; at the same time, the presence of informal caregivers at the patient’s bedside should be promoted.