title: Twelve-month mortality and functional outcomes in hip fracture patients under 65 years of age.
abstract: BACKGROUND
  There has been a recent call for improved functional outcome reporting in younger hip fracture patients. Younger hip fracture patients represent a different population with different functional goals to their older counterparts. Therefore, previous research on mortality and functional outcomes in hip fracture patients may not be generalisable to the younger population. The aims of this study were to report 12-month survival and functional outcomes in hip fracture patients aged <65 years and predictors of functional outcome.
  
  
  METHODS
  Hip fracture patients aged <65years (range 17-64) registered by the Victorian Orthopaedic Trauma Outcomes Registry over four years were included and their 12-month survival and functional outcomes (Extended Glasgow Outcome Scale) reported. Ordered multivariable logistic regression was used to identify predictors of higher function.
  
  
  RESULTS
  There were 507 patients enrolled in the study and of the 447 patients (88%) with 12-month outcomes, 24 (5%) had died. The majority of patients had no comorbidities or pre-injury disability and were injured via road trauma or low falls. 40% of patients sustained additional injuries to their hip fracture. 23% of patients had fully recovered at 12 months and 39% reported ongoing moderate disability. After adjusting for all key variables, odds of better function 12-months post-fracture were reduced for patients with co-morbidities, previous disability or additional injuries, those receiving compensation or injured via low falls.
  
  
  CONCLUSIONS
  While 12-month survival rates were satisfactory in hip fracture patients aged under 65 years, their functional outcomes were poor, with less than one quarter having fully recovered 12 months following injury. This study provides new information about which patients may have difficulty returning to their pre-injury level of function. These patients may require additional or more intensive post-discharge care in order to fulfil their functional goals and continue to contribute productively to society.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: christina.ekegren@monash.edu.
authors.forename: C L
authors.initials: CL
authors.lastname: Ekegren
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, Australia.
authors.forename: E R
authors.initials: ER
authors.lastname: Edwards
authors.affiliation: Department of Orthopaedics, University Hospital Geelong, Geelong, Australia; School of Medicine, Deakin University, Geelong, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Page
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Orthopaedic Surgery, Northern Hospital, Epping, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Hau
authors.affiliation: Epworth Hospital, Richmond, Australia; University of Melbourne, Parkville, Australia.
authors.forename: R
authors.initials: R
authors.lastname: de Steiger
authors.affiliation: Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Bucknill
authors.affiliation: Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Liew
authors.affiliation: Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Oppy
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: B J
authors.initials: BJ
authors.lastname: Gabbe
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000401:mortality* / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011787:Quality of Health Care; D015996:Survival Rate; D055815:Young Adult
keywords: Function; Hip fracture; Mortality; Orthopaedic injury; Outcomes; Trauma