Estimating Median Survival Following Hip Fracture Among Geriatric Females: (100 - Patient Age) ÷ 4

Abstract

Background: Estimated life expectancy for patients with geriatric hip fracture can help guide treatment selection, especially the choice between hemiarthroplasty and total hip arthroplasty for a femoral neck fracture. The purpose of the present study is to determine the survival pattern of a large cohort of geriatric female patients with hip fracture, as a function of age, for 10 years or more after injury.

Methods: All female patients between the ages of 65 and 99 who were treated surgically for hip fractures within the Veterans Affairs healthcare system from 2000 to 2010 were assessed. For every patient, the age at surgery and the age at death (if any) were recorded as of August 2021, a date at least 10.5 years after surgery. Results: There were 818 patients in the cohort. The mean age at the time of fracture treatment was 81.2 years. Femoral neck fractures were found in 58% of the population. The survival rate for the entire group at one year was 73.7%; at two years, 62.7%; at five years, 38.6%; and at 10 years,13.7%. The median length of survival was 3.42 years, decreasing by age: for the 65-69 cohort, median survival was 8.18 years, whereas, for those 90 and above, median survival was 1.75 years. Median life expectancy could be approximated by the equation (100 - Patient Age) ÷ 4. Survival was not meaningfully affected by fracture type. Conclusions: Geriatric hip fracture is associated with a high mortality rate. The median survival is highly correlated with age, such that an estimation equation, (100 - Patient Age) ÷ 4, offers a reliable shorthand for approximating it.

Keywords: femoral neck fracture; geriatrics; hip fracture; hip hemi-arthroplasty; life-expectancy; medical decision making; post-operative mortality; su (1): shared-decision making; total hip arthroplasty: tha; total joint arthroplasties.

Figure 1. Survival after fracture