title: Factors increasing mortality of the elderly following hip fracture surgery: role of body mass index, age, and smoking.
abstract: OBJECTIVE
  Hip fracture is one of the most common public health problems with a significant financial burden on the patient and on the healthcare system. This study was conducted to assess the 3-month and 1-year mortality rates of patients with operated hip fractures and to determine the influence of predictors of mortality.
  
  
  METHODS
  In this prospective cross-sectional study, all admitted patients aged more than 50 years with hip fracture at Chamran Hospital from January 2008 to August 2013 were enrolled. The characteristic data obtained included demographic information, body mass index (BMI), smoking, any previous history of osteoporotic fracture, and comorbidities. In addition, the mechanism of fracture, fracture type, and treatment method were recorded. A follow-up with the patients was conducted at 3 months and 1 year through a telephonic interview to ask about possible mortalities. Statistical analyses were performed using SPSS software version 17.0 for Windows.
  
  
  RESULTS
  A total of 1015 patients aged 50 years and older with hip fracture underwent surgery. Only 724 patients (71.3 %) completed the survey and the 1-year follow-up interview. The mean age was 75.7 ± 10.6 years. Overall, the 3-month and 1-year mortality rates were 14.5 and 22.4 %, respectively. Multivariate logistic regression analysis recognized age (OR 1.08; 95 % CI 1.05, 1.11, p < 0.001), BMI (OR 0.88; 95 % CI 0.82, 0.96, p = 0.003), and smoking (OR 1.76; 95 % CI 1.05, 2.96, p = 0.03) as major independent risk factors for mortality.
  
  
  CONCLUSIONS
  It is clear that modifiable factors like quitting the habit of smoking and gaining more energy with better nutrition could reduce the mortality rate if hip fracture occurs in the elderly.
authors.affiliation: Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: A R
authors.initials: AR
authors.lastname: Vosoughi
authors.affiliation: Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: M J
authors.initials: MJ
authors.lastname: Emami
authors.affiliation: Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Pourabbas
authors.affiliation: Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. drmahdavih@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Mahdaviazad
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007297:Inpatients; D007492:Iran / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D010024:Osteoporosis / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013689:Telephone; D016896:Treatment Outcome
keywords: Age; Elderly; Fracture; Hip; Mortality; Smoking