Predictors of mortality after hip fracture: results from 1-year follow-up.
OBJECTIVE
The study investigates one-year mortality risk associated with hip fracture in elderly people, and pre-fracture characteristics and events occurring during the acute phase which may represent significant predictors for acute and long-term mortality.


METHODS
The study is a prospective cohort study of 252 patients aged 70 and older, consecutively admitted with hip fracture to the Division of Orthopedic Surgery of the Galliera Hospital of Genoa, Italy. At admission, each subject received a standardized diagnostic evaluation, including demographic variables, biochemical markers of nutritional status and basic medical, functional and cognitive assessment. Patients were followed by telephone interviews at three months, six months and one year after fracture. The relationship between mortality and the risk factors recorded was assessed using logistic regression models.


RESULTS
248 patients were eligible. Cumulative mortality was 4.8% during hospital stay, and 12.5% at 3, 18.9% at 6 and 24% at 12 months. The risk factors significantly associated with mortality were: sex, Acute Physiology Score (APS), comorbidity, functional and cognitive status, and albumin levels. In multivariate models, albumin below 3 g/dL remained the only significant predictor of in-hospital mortality (OR 6,8, 95% CI 1.56-29,7, p<0.001); functional status and comorbidity were significant risk factors of mortality after 6 and 12 months.


CONCLUSIONS
These findings confirm the important role of serum albumin in assessing in-hospital health status and defining its role as a strong predictor of early and late mortality after hospital discharge. They also emphasize the effects of comorbidity and functional impairment on long-term mortality after hip fracture. Identifying these predictive factors may be helpful in improving case management during hospital stay and more accurate discharge planning.
Pioli
Giulio
G
Orthogeriatric Unit, Department of Geriatrics and Muscoloskeletal Sciences, E.O. Galliera Hospital, Corso Mentana 10, 16128, Genova, Italy.
Barone
Antonella
A
Giusti
Andrea
A
Oliveri
Mauro
M
Pizzonia
Monica
M
Razzano
Monica
M
Palummeri
Ernesto
E
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006620:Hip Fractures / Q000097:blood / Q000401:mortality* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D012737:Sex Factors
D012709:Serum Albumin