title: Assessment of mortality risk in elderly patients after proximal femoral fracture.
abstract: Mortality after hip fracture is a major problem in the Western world, but its mechanisms remain uncertain. This study assessed the 2-year mortality rate after hip fracture in elderly patients by including hospital factors (eg, intervention type, surgical delay), underlying health conditions, and, for a subset, lifestyle factors (eg, body mass index, smoking, alcohol). A total of 828 patients (183 men) 70 to 99 years old experiencing a hip fracture in 2009 in the province of Varese were included in the study. The risk factors for death were assessed through Kaplan-Meier analysis and Cox proportional hazards analysis. Hip fracture incidence per 1000 persons was higher in women (8.4 vs 3.7 in men) and in elderly patients (12.4 for 85-99 years vs 4.4 for 70-84 years). The mortality rate after 1, 6, 12, and 24 months was 4.7%, 16%, 20.7%, and 30.4%, respectively. For the province of Varese, sex (hazard ratio, 0.39 for women), age group (hazard ratio, 2.2 for 85-99 years), and Charlson Comorbidity Index score (hazard ratio, 2.06 for score greater than 1) were found to be statistically significant. The 2-year mortality rate in hip fractures is associated with sex, age, and comorbidities. Male sex, age older than 85 years, and Charlson Comorbidity Index score greater than 1 are associated with a higher risk. Surgical delay was significant in the Kaplan-Meier survival time analysis but not in the Cox hazard analysis, suggesting that early surgery reduces risk in patients with numerous comorbidities.
authors.forename: Jennifer M T A
authors.initials: JM
authors.lastname: Meessen
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pisani
authors.forename: Maria L
authors.initials: ML
authors.lastname: Gambino
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonarrigo
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
authors.forename: Stefania
authors.initials: S
authors.lastname: Fozzato
authors.forename: Paolo
authors.initials: P
authors.lastname: Cherubino
authors.forename: Michele F
authors.initials: MF
authors.lastname: Surace
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D014850:Waiting Lists / Q000401:mortality*