Key result
Hip fracture surgery during 2018-2020 was associated with a significant decline in 1-year mortality to 11.9% compared to 16.1% in 2010-2012, though it remained higher than the general population.
Why the study?
Data on mortality after hip fracture surgery in recent years are scarce, leaving it unclear whether initiatives introduced over the last decade have improved 1-year mortality.
Does modern hip fracture management (2018-2020) reduce 1-year mortality in elderly patients compared to the previous decade (2010-2012)?
Cohort (n=1,233)
No
Does modern hip fracture management (2018-2020) reduce 1-year mortality in elderly patients compared to the previous decade (2010-2012)?
Absolute Event Rate: 11.9% vs 16.1%
p-value: p=0.023
One-year mortality after hip fracture surgery has significantly declined over the last decade, though it remains higher than the general population.
Decline in 1-year hip fracture mortality supports care initiatives; leaves open whether targeted efforts can close excess risk versus general population.
OBJECTIVE: There are scarce data on the mortality after hip fracture surgery for patients treated in the most recent years. The objective of this study was to analyze whether the overall initiatives introduced over the last decade for elderly patients with hip fractures had a positive impact on the 1-year mortality. METHODS: Patients treated during 2010-2012 were compared with patients treated during 2018-2020 for all-cause 1-year mortality. Variables influencing mortality were collected based on the literature, including demographic, comorbidity, cognitive status, and preinjury physical function. Crude mortalities were compared between periods, as well as with the expected mortality in the general population adjusted for age, gender, and year of surgery using the standardized mortality ratio (SMR). A multivariate model was used to identify mortality risk factors. RESULTS: 591 patients older than 65 years were treated during 2010-2012 and 642 patients during 2018-2020. The mean age increased significantly between periods (78.9 vs. 82.6 years, respectively, p = 0.001) in both genders, together with an increase in comorbidity (p = 0.014). The in-hospital mortality risk had no significant difference between periods (2.5 vs. 2.0%, p = 0.339), but the 30-day mortality risk (8.3 vs. 5.5%, p = 0.031) and 1-year mortality risk (16.1 vs. 11.9%, p = 0.023) declined significantly. However, 1-year mortality in 2020 had an excess of 1.33 in SMR. Age older than 80 years, male gender, and Charlson comorbidity index > 2 were significant predictors of 1-year mortality. CONCLUSION: The important evolution achieved in the last decade for the management of patients with hip fracture surgery has led to a significant decline in 1-year mortality, but the 1-year mortality remains significantly higher compared to the general population of similar age and gender.
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Miralles‐Muñoz et al. (2022) conducted a cohort in Hip fracture (n=1,233). Hip fracture surgery during 2018-2020 vs. Hip fracture surgery during 2010-2012 was evaluated on 1-year all-cause mortality (p=0.023). Hip fracture surgery during 2018-2020 was associated with a significant decline in 1-year mortality to 11.9% compared to 16.1% in 2010-2012, though it remained higher than the general population.