title: Early mortality after hip fracture: what matters?
abstract: BACKGROUND
  Hip fractures in the elderly are followed by increased mortality, which is highest in the period immediately after the fracture. Predictors for early mortality have neither been well identified nor summarized. Identification of early postoperative mortality predictors enables the stratification of high-risk patients and can help in the development of strategies aimed at reducing risk and improving outcome after hip fracture. The primary aim of this study was to investigate the incidence of 30-day mortality. The secondary aim was to investigate factors related to early mortality.
  
  
  METHODS
  We examined 384 elderly patients with hip fracture. Multivariate logistic regression analysis was used to explore independent prognostic factors for 30-day mortality.
  
  
  RESULTS
  By the end of the 30-day follow-up period, 22 patients (6.4%) had died. Postoperative delirium was the only variable independently related to 30-day mortality after hip fracture. Older, male patients with a lower cognitive status had a higher chance of developing postoperative delirium.
  
  
  CONCLUSIONS
  Postoperative delirium is a strong independent marker of high risk for 30-day mortality. Older, male patients with more severe cognitive impairment are at increased risk of developing postoperative delirium. Identifying patients at risk for developing postoperative delirium upon admission and early detection of delirium enable the development of targeted prevention and intervention strategies in older patients with hip fracture.
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, Belgrade, Serbia.
authors.forename: Emilija
authors.initials: E
authors.lastname: Dubljanin Raspopovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Markovic Denic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Institute of Medical Statistics and Medical Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Marinkovic
authors.affiliation: Institute of Anesthesia and Reanimation, Clinical Center Serbia, Belgrade, Serbia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Radinovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, Belgrade, Serbia.
authors.forename: Nela
authors.initials: N
authors.lastname: Ilić
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, Belgrade, Serbia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Tomanović Vujadinović
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Serbia, Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Kadija
keywords: cognitive impairment; delirium; hip fracture; mortality; risk factors