Observational study on the comparability of the clinical profiles of older adults with hip fractures and pelvic fractures in Germany.

Abstract

Background/objective: Orthogeriatric co-management (OGCM) significantly improves outcomes in older adults with hip fractures; however, it remains unclear whether older adults with pelvic fractures can similarly benefit. This study aimed to compare clinical and geriatric profiles of older adults with hip fractures and pelvic fractures across relevant medical and geriatric domains. Demonstrating comparable profiles would support future prospective studies evaluating OGCM in patients with pelvic fractures.

Methods: We retrospectively analyzed data from an ongoing observational study at our institution including 611 hospitalized adults aged 70 years or older with hip fractures (n = 535) or pelvic fractures (n = 76). Variables included age, functional status, comorbidity burden and incidence of delirium. Group comparisons were performed using the χ²-test for categorical variables and the Kruskal-Wallis test for continuous variables. After Bonferroni adjustment, a p-value < 0.005 was considered statistically significant. The study was approved by the Ethics Committee of the Medical Faculty of Heinrich Heine University.

Results: The median age was 85 years (interquartile range 80-89 years) and 69% of patients were female. Hip fractures accounted for 87.6% of cases and pelvic fractures for 12.4%. Both groups showed a high burden of comorbidity and geriatric impairment, including cognitive impairment, functional limitations, frailty and medical comorbidity. Most clinical parameters were comparable between groups. Although surgery was performed much more frequently in the hip fracture group, no significant differences in the overall medical and geriatric profiles were observed except for transfusion rate and postoperative delirium.

Conclusion: Older adults with hip fractures and pelvic fractures have largely comparable clinical and geriatric profiles. Given the established benefits of OGCM in hip fracture care, a similar approach could also benefit patients with pelvic fractures. This hypothesis should be evaluated in future prospective interventional studies.