Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar;9(1):10-18.
doi: 10.4055/cios.2017.9.1.10. Epub 2017 Feb 13.

A Comprehensive Analysis of the Causes and Predictors of 30-Day Mortality Following Hip Fracture Surgery

Hassaan Qaiser Sheikh  1 , Fahad Siddique Hossain  2 , Adeel Aqil  1 , Babawande Akinbamijo  1 , Vhaid Mushtaq  1 , Harish Kapoor  1
Affiliations

A Comprehensive Analysis of the Causes and Predictors of 30-Day Mortality Following Hip Fracture Surgery

Hassaan Qaiser Sheikh et al. Clin Orthop Surg. 2017 Mar.

Abstract

Background: A fracture neck of femur is the leading cause of injury-related mortality in the elderly population. The 30-day mortality figure is a well utilised marker of clinical outcome following a fracture neck of femur. Current studies fail to analyse all patient demographic, biochemical and comorbid parameters associated with increased 30-day mortality. We aimed to assess medical risk factors for mortality, which are easily identifiable on admission for patients presenting with a fractured neck of femur.

Methods: A retrospective review of a prospectively populated database was undertaken to identify all consecutive patients with a fracture neck of femur between October 2008 and March 2011. All factors related to the patient, injury and surgery were identified. The primary outcome of interest was 30-day mortality. Univariate and subsequent multivariate analyses using a backward stepwise likelihood ratio Cox regression model were performed in order to establish all parameters that significantly increased the risk of death.

Results: A total of 1,356 patients were included in the study. The 30-day mortality was 8.7%. The most common causes of death included pneumonia, sepsis and acute myocardial infarction. Multiple regression analysis revealed male gender, increasing age, admission source other than the patient's own home, admission haemoglobin of less than 10 g/dL, a history of myocardial infarction, concomitant chest infection during admission, increasing Charlson comorbidity score and liver disease to be significant predictors of mortality.

Conclusions: This study has elucidated risk factors for mortality using clinical and biochemical information which are easily gathered at the point of hospitalization. These results allow for identification of vulnerable patients who may benefit from a prioritisation of resources.

Keywords: Epidemiology; Hip fractures; Mortality; Risk factors.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. 30-Day morality causes of death.
GI: gastrointestinal, COAD: chronic obstructive airways disease.
See this image and copyright information in PMC

References

    1. Cooper C, Cole ZA, Holroyd CR, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011;22(5):1277–1288. - PMC - PubMed
    1. Cooper C, Campion G, Melton LJ., 3rd Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992;2(6):285–289. - PubMed
    1. Hu F, Jiang C, Shen J, Tang P, Wang Y. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2012;43(6):676–685. - PubMed
    1. Khan MA, Hossain FS, Ahmed I, Muthukumar N, Mohsen A. Predictors of early mortality after hip fracture surgery. Int Orthop. 2013;37(11):2119–2124. - PMC - PubMed
    1. Royal College of Physicians. National Hip Fracture Database (NHFD) annual report 2014. London: Royal College of Physicians; 2014.

MeSH terms