Key result
Hip fracture surgery in the post-2018 aged society period was not associated with a significant difference in one-year postoperative mortality compared to the pre-2018 period (5.6% vs 6.5%; adjusted OR 1.38), though aspiration pneumonia emerged as a stronger mortality predictor.
Why the study?
As societies age, understanding the evolving risk factors and impact of comorbidities on postoperative mortality after hip fracture surgery is critical.
Does the transition to an aged society (post-2018) alter the risk factors and rates of 1-year postoperative mortality in older adults undergoing hip fracture surgery?
Cohort (n=1,545)
No
Does the transition to an aged society (post-2018) alter the risk factors and rates of 1-year postoperative mortality in older adults undergoing hip fracture surgery?
In older adults undergoing hip fracture surgery, 1-year mortality remained stable at 6.0% despite an aging population, but in-hospital complications like aspiration pneumonia and UGI bleeding emerged as increasingly critical predictors of mortality.
1-year mortality after hip fracture surgery remained stable despite aging; supports targeted prevention of aspiration pneumonia and UGI bleeding in future studies.
As societies age, understanding the impact of comorbidities on postoperative outcomes following hip fracture surgery becomes increasingly critical. This single-center retrospective study examines the evolving risk factors for postoperative mortality following hip fracture surgery among older adults in Taiwan during its transition to an aged society. We analyzed data from 1,545 patients aged over 65 years who underwent hip fracture surgery at Hualien Tzu Chi Hospital between 2011 and 2020, comparing outcomes before and after 2018-the year Taiwan officially became an aged society. The overall one-year postoperative mortality rate was 6.0%. Significant predictors of increased mortality included advanced age, male sex, ORIF surgical approach, hepatic disease, coronary artery disease, and notably, in-hospital complications such as aspiration pneumonia and UGI bleeding. Our findings revealed that aspiration pneumonia's impact on mortality intensified significantly in the post-2018 period, highlighting the changing risk profile as Taiwan's population ages. This study provides critical insights for developing targeted interventions and specialized postoperative care protocols for elderly hip fracture patients, particularly focusing on respiratory care and dysphagia screening. These findings have important implications for healthcare systems adapting to demographic shifts toward super-aged societies.
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Wu et al. (2025) conducted a cohort in Hip fracture (n=1,545). Surgery after January 1, 2018 (Post-Aged Society Group) vs. Surgery before January 1, 2018 (Pre-Aged Society Group) was evaluated on 1-year postoperative mortality (OR 1.38, 95% CI 0.86-2.22, p=0.178). Hip fracture surgery in the post-2018 aged society period was not associated with a significant difference in one-year postoperative mortality compared to the pre-2018 period (5.6% vs 6.5%; adjusted OR 1.38), though aspiration pneumonia emerged as a stronger mortality predictor.
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