Epidemiology and Mortality in Hip Fractures: Impact of Surgical Latency in a Cohort from a Public Hospital in Chile

• Published in: Revista medíca de Chile 2023-11, Vol.151 (11), p.1456
• Main Authors: Guiloff, Rodrigo, Valderrama, Carlos, Edwards, Diego, Contreras, Martín, Vaisman, Alex
• Format: Article
• Language: Spanish
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Chile - epidemiology; Female; Hip Fractures - mortality; Hip Fractures - surgery; Hospitals, Public - statistics & numerical data; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Time Factors; Time-to-Treatment - statistics & numerical data; Young Adult
• ISSN: 0717-6163; 0717-6163
• DOI: 10.4067/s0034-98872023001101456

Describe the epidemiology and mortality in hip fractures and their relationship with surgical latency. Retrospective study of patients with hip fracture, operated in a center between 2009-2016. Non-operated patients, periprosthetic fractures, and stress fractures were excluded. Patients were stratified into three groups according to their surgical latency in days (Group 1: < 2 days; Group 2: 2-7 days; Group 3: > 7 days). The mortality rate was calculated at 6, 12, and 24 months of follow-up and extrapolated to 96 months for statistical analysis using Cox regression (p < 0.05). Seven hundred and thirty-three patients were included with an average age of 75.3 years (17 to101 years), 71.4% were women, and 62.2% of the fractures were extracapsular. Group 1: n = 171 (23.3%). Mortality at 6, 12 and 24 months: 10.5%, 14.6%, 21.6%. Group 2: n = 436 (59.5%). Mortality at 6, 12 and 24 months: 14.0%, 20.2%, 27.3%. Group 3: n = 113 (17.2%). Mortality at 6, 12 and 24 months: 28.6%, 39.7%, 51.6%. Group 3 showed a 2.49 times higher risk (p = 0.01) of long-term mortality compared to Group 1, while Group 2 had a 1.31 times higher risk than Group 1 (p = 0.05). Age and gender demonstrated a significant association with long-term mortality (p = 0.01). Most of the hip fractures were extracapsular, in elderly and female patients. Surgical latency exhibited a significant and directly proportional relationship with mortality. Furthermore, male gender and older age at the time of fracture were factors associated with increased long-term mortality.