title: Predictors of in-hospital mortality following operative management of hip fractures.
abstract: OBJECTIVE
  To identify predictors of in-hospital mortality and hospital stay following hip fractures.
  
  
  METHODS
  Retrospective cohort study of 185 consecutive patients.
  
  
  METHODS
  Tertiary Care University Hospital.
  
  
  METHODS
  Individuals requiring operative treatment of a proximal femoral fracture excluding those individuals < 50 years old, with femoral head or subtrochanteric fractures, and significant co-morbidity.
  
  
  RESULTS
  In-hospital mortality and length of hospital stay (days).
  
  
  RESULTS
  116 patients met the inclusion criteria. Predictors of in-hospital mortality from logistic regression analysis included male gender (odds ratio with 95% CI: 5.5, 1.5-20.5), admission from a long term care facility (5.5, 1.4-22.6), age greater than 90 years (4.5, 0.9-22.1), and living at home with support (0.2, 0.03-0.9). Predictors of hospital stay from multivariate regression analysis in order of magnitude included presence of a post-operative complication (odds ratio with 95% CI: 14.1, 4.7-44), living at home with support (3.4, 1.3-8.9) and older age (> 85 years) (2.7, 1.0-7.3). Moreover, confusion, urinary tract infections and decubitus ulcers accounted for greater than 50% of all complications encountered. A trend between the number of positive predictors and length of hospital stay was observed.
  
  
  CONCLUSIONS
  Elderly individuals admitted from a long term care facility are at high risk of mortality following operative fixation of hip fractures. Early recognition and aggressive management of post-operative complications such as confusion, urinary tract infections and decubitus ulcers through careful patient monitoring may decrease hospital stays in those that survive.
authors.affiliation: Hamilton Civic Hospitals Research Center, Division of Orthopaedic Surgery, 711 Concession Street, Hamilton, Ontario, Canada L8V 1C3. bhandari@netinc.ca
authors.forename: M
authors.initials: M
authors.lastname: Bhandari
authors.forename: H
authors.initials: H
authors.lastname: Koo
authors.forename: L
authors.initials: L
authors.lastname: Saunders
authors.forename: S G
authors.initials: SG
authors.lastname: Shaughnessy
authors.forename: R B
authors.initials: RB
authors.lastname: Dunlop
authors.forename: E H
authors.initials: EH
authors.lastname: Schemitsch
mesh_terms: D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000401:mortality / Q000601:surgery; D006620:Hip Fractures / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies