title: Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture-An observational study.
abstract: OBJECTIVE
  To identify the factors associated to institutionalization and mortality in elderly patients with hip fractures (HF).
  
  
  METHODS
  Thirty-six months observational study.
  
  
  METHODS
  A post-acute rehabilitation ward.
  
  
  METHODS
  subjects living in the community or in nursing-home, above the age of 65, with HF.
  
  
  METHODS
  The following were registered: comorbidity, intra-hospital complications, Barthel index, walking ability and Mini Mental State Examination, as well as blood samples upon admission and discharge. Destination upon discharge was recorded as well as mortality during hospital stay and over the three-year follow up.
  
  
  RESULTS
  a total of 430 subjects were included in the study. Twenty-three patients (5.3%) died during their stay in hospital and 152 (35.3%) during follow up after discharge. Forty-five patients (10.5%) were institutionalized upon discharge. In adjusted analysis, the factors that predict intra-hospital mortality are higher comorbidity (OR, 1.46; 95%CI, 1.06-2.01), and the number of complications (OR, 1.71; 95%CI, 1.16-2.64). Factors that predict mortality in the long term are age (HR 1.04; 95%CI, 1.01-1.06), comorbidity (HR 1.19, 95% CI, 1.09-1.30), the number of complications (HR 1.17, 95%CI, 1.05-1.31). The factors that predicted new institutionalization were age (OR 1.04, 95%CI, 0.98-1.09), living alone (OR 3.95, 95%CI, 1.38-11.3), and length of hospital stay (OR 1.02 95%CI, 1.00-1.03).
  
  
  CONCLUSIONS
  Mortality 3 years after a hip fracture and institutionalization are associated to age, the loss of autonomy in walking, a worse cognitive status and living alone before the fracture. Identification of and, when possible, intervention upon these factors can improve care of elderly people with hip fractures.
authors.affiliation: Department of Geriatrics, Hospital San Juan de Dios, Pamplona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Uriz-Otano
authors.affiliation: Department of Psychiatry and Medical Psychology, Clinic of the University of Navarra, Pamplona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Pla-Vidal
authors.affiliation: Department of Internal Medicine, Hospital Virgen Del Camino, Pamplona, Spain.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Tiberio-López
authors.affiliation: Department of Geriatrics, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain. Electronic address: vmalafarina@gmail.com.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Malafarina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000401:mortality*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011446:Prospective Studies
keywords: Functional status; Hip fracture; Institutionalization; Mortality; Nursing home