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. 2023 May;35(5):1063-1071.
doi: 10.1007/s40520-023-02378-y. Epub 2023 Mar 9.

Functional autonomy and 12-month mortality in older adults with proximal femoral fractures in an orthogeriatric setting: risk factors and gender differences

Chiara Ceolin #  1 , Giulia Bano #  2 , Carlo Biz  3 , Marta Dianin  2 , Marco Bedogni  2 , Aurelio Guarnaccia  2 , Antonio Berizzi  3 , Pietro Ruggieri  3 , Alessandra Coin  2 , Giuseppe Sergi  2
Affiliations

Functional autonomy and 12-month mortality in older adults with proximal femoral fractures in an orthogeriatric setting: risk factors and gender differences

Chiara Ceolin et al. Aging Clin Exp Res. 2023 May.

Abstract

Background: Proximal femur fractures have a negative impact on loss of functional autonomy and mortality.

Objective: The aim of this retrospective study was to evaluate functional autonomy and mortality in a group of older adults with hip fractures managed in an orthogeriatric setting 12 months after discharge and to determine if gender affected outcome.

Methods: In all participants, we assessed clinical history, functional pre-fracture status using activities of daily living (ADL) and in-hospital details. At 12 months after discharge, we evaluated functional status, place of residence, hospital readmissions and mortality.

Results: We studied 361 women and 124 men and we observed a significant reduction in the ADL score at 6 months (1.15 ± 1.58/p < 0.001 in women and 1.45 ± 1.66/p < 0.001 in men). One-year mortality (33.1% in men and 14.7% in women) was associated with pre-fracture ADL score and reduction in ADL at 6 months (HR 0.68/95%, CI 0.48-0.97/p < 0.05 and HR 1.70/95%, CI 1.17-2.48/p < 0.01, respectively) in women, and new hospitalisations at 6 months and polypharmacy in men (HR 1.65/95%, CI 1.07-2.56/p < 0.05 and HR 1.40/95%, CI 1.00-1.96/p = 0.05, respectively) in Cox's regression model.

Discussion and conclusions: Our study suggests that functional loss in older adults hospitalised for proximal femur fractures is greatest in the first 6 months after discharge, and this increases the risk of death at 1 year. Cumulative mortality at 12 months is higher in men and appears to be related to polypharmacy and new hospital admissions 6 months after discharge.

Keywords: Functional recovery; Gender; Hip fractures; Mortality; Older people; Orthogeriatrics.

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