Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

INTRODUCTION: The clinical outcome of geriatric patients with hip fracture depends on surgical management as well as other medical factors. This study aimed to evaluate the relationship between Charlson comorbidity score and in-patient, 30-day, and 1-year mortality in Chinese geriatric patients who underwent surgery for hip fracture. METHODS: This was a historical cohort study conducted in a tertiary trauma referral centre in Hong Kong. From 1 January 2009 to 31 December 2010, 759 operated hip fracture patients who were over 65 years were recruited. The Charlson Comorbidity Index of each patient was retrieved from their medical records. The total Charlson comorbidity score, the highest Charlson comorbidity score, and the Charlson comorbidity score were calculated. The associations between these scores and in-patient, 30-day, and 1-year mortality were examined using Mann-Whitney U test and Cox regression model. RESULTS: The mean in-patient, 30-day, and 1-year mortality rate was 0.8%, 2.5%, and 16.3%, respectively. The total Charlson comorbidity score was significantly associated with in-patient mortality (P=0.031). The total Charlson comorbidity score (P<0.001) and Charlson comorbidity score (P=0.010) were significantly associated with 30-day mortality. All three scores were also significantly related to 1-year mortality (P<0.001). A Cox regression model demonstrated the relationship between total Charlson comorbidity score and 30-day and 1-year mortality. This can help predict 30-day and 1-year mortality risk in geriatric patients admitted for hip fracture surgery. CONCLUSION: The Charlson comorbidity score provides a good preoperative indicator of 30-day and 1-year mortality in geriatric patients with hip fracture.