Fragility hip fractures among Nigerian older adults: a retrospective study of epidemiology, mobility and mortality outcomes at 3 and 12 months post-hospital discharge

Summary

Fragility hip fractures (FHFs) are a growing concern worldwide. Sub-Saharan Africa is no exception. Nigeria has limited data on FHFs. This study found that surgical treatment significantly enhances mobility and survival rates for older adults with FHFs. The findings can inform healthcare policies and practices in Nigeria and similar contexts.

Purpose

The global population, including that of sub-Saharan Africa, is rapidly ageing, resulting in a higher incidence of fragility fractures. This study investigates the epidemiology of fragility hip fractures (FHFs) at a Nigerian teaching hospital, focusing on the predictors of two key outcomes: (1) mobility and mortality 3 months post-discharge, and (2) mortality 12 months post-discharge.

Methods

A retrospective study was conducted involving 102 older adults aged ≥ 60 who received treatment for femoral neck, intertrochanteric, and subtrochanteric fractures at a mission teaching hospital in Nigeria over 6 years. Data collected included demographics, causes of fractures, comorbidities, treatment methods, time-to-surgery, length of stay, mobility, and mortality rates. Univariate analyses were performed to identify mobility and mortality outcomes predictors at 3 and 12 months post-discharge.

Results

The mean age was 78.0 years, with 49.0% of patients in the oldest-old category. 70.6% regained mobility 3 months post-discharge. The mortality rate was 3.9% at 3 months and 22.5% at 12 months. Predictors of better mobility and mortality outcomes included younger age, no/mild comorbidities, fractures due to community falls, femoral neck fractures, surgical treatment, and shorter time to surgery. Patients who regained mobility by 3 months had a lower 12-month mortality rate (p < 0.001).

Conclusion

This study emphasizes the importance of effective surgical management for FHFs in Nigeria’s ageing population. The findings suggest that a multidisciplinary care approach, encompassing comprehensive management of comorbidities, age-friendly housing design, ongoing research, and investment in healthcare infrastructure, is essential to address the growing burden of FHFs.