Factors determining the 1-year survival after operated hip fracture: a hospital-based analysis.
BACKGROUND
Factors associated with 1-year survival of hip fracture in Chinese ethnicities has not been clearly elucidated. The purpose of this study was to determine the 1-year survival associated with operated hip fracture and its prognostic factors in a district teaching hospital from January 1, 1998 to 2006.


METHODS
Hip fracture admissions (ICD-9: 820) identified from an inpatient electronic database over a 9-year period were linked to Taiwan's national death registry. Actuarial analysis was used to determine the 1-year survival rates after hip fracture, which were further compared according to different concurrent illnesses. We used the Cox proportional hazard regression model to explore the significant determinants of 1-year survival of the study patients.


RESULTS
The overall 1-year survival rate of all patients was 86%. This was lower if the operation was accompanied by certain co-morbidities, including heart failure [hazard ratio (HR) 6.12; 95% confidence interval (CI) 1.54-24.36], chronic obstructive pulmonary disease (HR 2.40; 95% CI 1.14-5.05), and pneumonia (HR 4.26; 95% CI 1.95-9.31). In addition, elderly patients (>84 years of age) (HR 7.34; 95% CI 2.49-21.58), arthroplasty (HR 3.69; 95% CI 1.10-12.43), operative delay >48 h (HR 2.86; 95% CI 1.08-7.54), low preoperative hemoglobin level (<11 g/dl) (HR 2.58; 95% CI 1.33-5.01), and high creatinine level (>or=2 mg/dl) (HR 2.52; 95% CI 1.07-5.95) were all significantly associated with increased mortality.


CONCLUSIONS
The 1-year survival for patients in this study hospital, 86%, was comparable to or higher than that of previous studies. Improved survival rates among hip fracture patients may be achieved by early recognition and prompt treatment of associated medical illnesses.
Department of Orthopedic Surgery, Catholic Mercy Hospital, Hsinchu County, Taiwan.
Ching-An
CA
Ho
Chung-Yi
CY
Li
Kou-Shiong
KS
Hsieh
Hua-Fen
HF
Chen
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006333:Heart Failure / Q000150:complications; D006620:Hip Fractures / Q000150:complications / Q000208:ethnology* / Q000401:mortality*; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012307:Risk Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology