Predictors of mortality in older hip fracture inpatients admitted to an orthogeriatric unit in oslo, norway.
OBJECTIVE
To identify to which degree patient-related factors (age, gender, place of residence, general health condition, comorbidity) and hospital-related factors (waiting time for surgery, type of surgery, in-hospital complications, length of stay) may predict 1-year mortality in elderly hip fracture patients in an orthogeriatric unit, to optimize treatment and care.


METHODS
In-hospital patient information was routinely collected by multidisciplinary staff and entered into a database. Information about mortality was obtained for 567 patients aged 65 and above. Multivariate logistic regression was performed.


RESULTS
Overall mortality was 23.5%, but there was a large variation in mortality according to age, gender, comorbidity, and place of residence. Independent predictors of mortality were admittance from nursing home (risk ratio [RR] = 3.24, 95% confidence interval [CI] = 2.37-4.43 compared with home dwellers) and a higher American Society of Anesthesiologists (ASA) score (RR = 1.75 and 95% CI = 1.24-2.46, for ASA ≥ 3 compared with ASA ≤ 2). Male gender, increasing age, increasing number of comorbid conditions, and having fallen indoors were indicators, but not independent predictors, of higher mortality.


CONCLUSIONS
Almost one fourth of older hip fracture patients in this unit died within a year. The most important predictor was admittance from nursing home, which was associated with comorbidity and frailty. More attention to patients from nursing homes is needed in the health care system.
Holvik
Kristin
K
Department of Surgery, Diakonhjemmet Hospital, Oslo, Norway. kristin.holvik@medisin.uio.no
Ranhoff
Anette Hylen
AH
Martinsen
Mette Irene
MI
Solheim
Ludvig Fjeld
LF
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005853:Geriatrics; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D009026:Mortality / Q000639:trends*; D009664:Norway / Q000453:epidemiology; D012044:Regression Analysis; D012306:Risk; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis