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. 2018 Sep 14;13(1):235.
doi: 10.1186/s13018-018-0936-5.

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

Simon Kwoon-Ho Chow  1 , Jiang-Hui Qin  2 , Ronald Man-Yeung Wong  1 , Wai-Fan Yuen  1 , Wai-Kit Ngai  3 , Ning Tang  1 , Chor-Yin Lam  4 , Tak-Wing Lau  5 , Kin-Bong Lee  6 , Kwai Ming Siu  7 , Sze-Hung Wong  8 , Tracy Y Zhu  1 , Wing-Hoi Cheung  9 , Kwok-Sui Leung  1
Affiliations

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

Simon Kwoon-Ho Chow et al. J Orthop Surg Res. .

Abstract

Background: The purpose of this registry-based retrospective study was to investigate the risk factors related to one-year mortality in displaced intracapsular fragility hip fracture patients.

Methods: Patients were screened from the Fragility Fracture Registry. Inclusion criterion was displaced intracapsular hip fracture patients with atypical or pathological fractures excluded. One-year mortality was investigated against risk factors including age, gender, past medical history, pre-fracture mobility (PFM), pre-operation ASA grade, delayed surgery over 48 h, post-surgical complications, and length of stay at acute orthopedic ward (LOS).

Results: A total of 1050 patients were included for further analysis. Gross one-year mortality was 14.9%. One-year mortality was significantly higher in patients who received non-operative treatment and those who received surgery but delayed over 48 h after admission (both p < 0.001). Male gender (OR = 2.708), advanced age (OR = 1.359), higher risk ASA grades (III to V) (OR = 1.990), past history of gastrointestinal disease (OR = 1.671), and renal impairment (OR = 1.984) were related to higher one-year mortality. The mortality of patients in PFM grade 3 and LOS group 3 was significantly higher (OR = 2.240 and 1.722, respectively).

Conclusions: Higher age, male gender, past gastrointestinal disease and renal impairment, ASA grade over 3, indoor confined pre-fracture ambulatory, and stay at hospital over 15 days were risk factors related to higher one-year mortality in surgically treated displaced intracapsular hip fracture patients. A multi-disciplinary approach is advised to patients identified with these risks factors and co-managed by orthopedic surgeons, geriatricians, and fracture liaison nurses.

Keywords: Fragility Fracture Registry; Intracapsular fragility hip fracture; One-year mortality; Risk factors.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approvals were obtained from the Research Ethics Committee (REC) of all six hospitals (reference numbers: KW/EX-13-094(65–06(CMC)) at the Caritas Medical Centre, KW/EX-13-095(65–06(PMH)) at the Princess Margaret Hospital, CT-209/2013 at the Prince of Wales Hospital, KC/KE-13-0106/ER-2 at the Queen Elizabeth Hospital, UW-13-379 at the Queen Mary Hospital, and NTWC/CREC/1170/13 at the Tuen Mun Hospital). The study was done in accordance with the principles outlined in the Declaration of Helsinki [1].

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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