Mortality Rates and Forensic Causes after Hip Fracture: A Retrospective Observational Study.

Abstract

Objectives: Despite the widely recognised high mortality rate among patients with hip fracture, the variation in death rates by gender and cause has been less explored. This study aimed to investigate mortality rates and causes of death in patients who underwent hip fracture surgery, and to compare them with those of the general population. A secondary objective was to compare the results of Internal Fixation versus Arthroplasty in these patients.

Methods: A population-based study collected records of 356 consecutive cases of hip fracture. For comparison purposes, data from the general population were also collected, which included residents of Adana city of 65 years and older. Causes of mortality were classified as cancer, dementia, heart disease, lung disease, and digestive disorders, among others. The average follow-up period was 4.2 years, ranging from 0 to 5 years.

Results: 105 (29.49%) of the surgical patients perished in one year. At the end of the follow-up, n = 308 (86.52%) of the hip fracture patients had died. Age-adjusted mortality rates after hip fracture surgery were higher for men than for women, with a risk ratio (HR) of 1.48 and a 95% confidence interval (CI) between 1.07 and 2.15. Complications from heart, lung, or blood vessel diseases were the leading causes of death after hip replacement surgery, followed by Alzheimer's disease and dementia. Men were more susceptible to respiratory diseases, cancer, and heart and blood vessel diseases than women. After hip fracture, both the overall mortality rate and the gender-standardised death rate were three times that of the general population for each cause of death.

Conclusion: During the study period, the mortality risk for hip fracture patients was three times that of the general population for the primary causes of death.