Key result
No preoperative mobility linked to ~86% higher one-year mortality after hip fracture surgery.
Why the study?
Decreased preoperative mobility increases the risk of decline and postoperative mortality in frail hip fracture patients, prompting investigation into its correlation with 1-year mortality and postoperative mobility.
Does preoperative mobility predict 1-year mortality and postoperative mobility in patients undergoing hip fracture surgery?
Cohort (n=77,185)
Yes
Does preoperative mobility predict 1-year mortality and postoperative mobility in patients undergoing hip fracture surgery?
Effect estimate: HR 1.86 for no functional mobility group (FMS 5) vs freely mobile group (FMS 1) (95% CI 95% CI 1.65-2.09)
p-value: p=<0.001
Lower preoperative mobility is an independent predictor of increased 1-year mortality following hip fracture surgery.
Supports preoperative mobility assessment for risk stratification; reinforces its independent prognostic value for 1-year mortality.
Background/Objectives: Decreased preoperative mobility increases the risk of decline and postoperative mortality in a frail patient with a hip fracture. This study investigates the correlation between preoperative mobility and 1-year mortality and between pre- and postoperative mobility. Methods: This retrospective, national cohort study used data from the Dutch Hip Fracture Audit (2018–2023). Excluded patients were those with an indication for a total hip arthroplasty, non-surgical treatment or missing data on mortality or preoperative mobility. Mobility was determined by the Fracture Mobility Score (FMS). A Cox proportional-hazards regression model assessed the correlation between FMS and mortality by using hazard ratios with 95% confidence intervals. A subgroup analysis was conducted for patients whose data on postoperative mobility was complete. Spearman’s test was used to assess the correlation between pre- and postoperative mobility. A p-value < 0.05 was considered statistically significant in both analyses. Results: A total of 77,185 patients were included in the study. A Cox regression model shows a stepwise increase in risk of death with a lower preoperative FMS, after correction of confounders. Those with no functional mobility showed the highest risk of death within 1 year after surgery (HR 1.86, 95% CI 1.65–2.09, p < 0.001). Spearman’s correlation demonstrated a moderate positive correlation between pre- and postoperative mobility, which is demonstrated by ρ = 0.49 (p < 0.001). Conclusions: Preoperative mobility seems to be an independent predictor of 1-year mortality. Additionally, this study demonstrated a moderate positive correlation between pre- and postoperative mobility.
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Groen et al. (2026) conducted a cohort in Patients admitted to emergency departments with traumatic hip fracture undergoing surgery excluding total hip arthroplasty indication and non-surgical treatment (n=77,185). Preoperative mobility status assessed by Fracture Mobility Score (FMS) vs. Freely mobile group (FMS 1) was evaluated on 1-year all-cause mortality after hip fracture surgery (HR 1.86 for no functional mobility group (FMS 5) vs freely mobile group (FMS 1), 95% CI 95% CI 1.65-2.09, p=<0.001). Preoperative mobility status independently predicted 1-year mortality after hip fracture surgery, with patients having no functional mobility (FMS 5) showing an 86% increased risk of death (HR 1.86, 95% CI 1.65–2.09, p<0.001) compared to freely mobile patients.
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