Effect of comorbidities on the association between age and hospital mortality after fall-related hip fracture in elderly patients.
The relation between age and mortality after hip fracture was analyzed in elderly patients. 5.5% of the 31,884 patients died. Compared to those 65-74 years old, the multivariate OR for mortality for those 75-84 and ≥85 were 2.11 (95% CI: 1.61-2.77) and 4.10 (95% CI: 3.14-5.35).



To analyze the impact of Elixhauser comorbidities on the relation between age and mortality after hip fracture in elderly patients.



Cross-sectional study of the population ≥65 years old hospitalized in Spain in 2013 with a diagnosis of fall-related hip fracture in the Basic Minimum Set Data (BMSD). The impact of Elixhauser comorbidities on the association between mortality and age groups (65-74, 75-84, ≥85) was analyzed by logistic regression models with progressive adjustment for demographic variables and comorbidities introduced individually.



We identified 31,884 patients, 5.5% of which died during hospitalization. Compared with those 65-74 years old, the multivariate OR of mortality for those 75-84 and ≥85 years old decreased from 2.23 (95% CI: 1.71-2.90) and 4.57 (95% CI: 3.54-5.90) to 2.11 (95% CI: 1.61-2.77) and 4.10 (95% CI: 3.14-5.35), respectively after adjustment for comorbidities. The OR of mortality for men was 1.77 (95% CI: 1.58-1.98) compared to women. The comorbidities with higher OR for mortality were congestive heart failure (OR: 3.88; 95% CI: 3.42-4.41), metastasis (OR: 3.44; 95% CI: 2.27-5.20), fluid and electrolyte disorders (OR: 2.95; 95% CI: 2.47-3.52), coagulation deficiencies (OR: 2.87; 95% CI: 2.08-3.96), and liver disease (OR: 2.40; 95% CI: 1.82-3.17).



The association between age and mortality after hip fracture remains after adjusting for numerous comorbidities. However, some potentially controllable disorders are associated with an increased risk for mortality, thus, improving their management could benefit survival.
National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain. a.padronm@isciii.es.
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Padrón-Monedero
National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain.
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López-Cuadrado
National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain.|Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, C/Arzobispo Morcillo 2, Madrid, Spain.
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Galán
National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), C/Melchor Fernandez Almagro 3-5, Madrid, Spain.
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Martínez-Sánchez
Adelphi University, College of Nursing and PH, Garden City, NY, 11530, USA.
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Martin
National Centre for Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), C/Melchor Fernandez Almagro 3-5, Madrid, Spain.
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Fernández-Cuenca
D000058:Accidental Falls / Q000401:mortality*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000401:mortality*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
Comorbidities; Elderly; Falls; Mortality