Predictors of Hip Fracture Among Patients With Atrial Fibrillation: A Retrospective Study

Background Hip fractures represent a major public health concern among elderly individuals, with annual cases projected to exceed six million globally by 2050 due to population aging. Patients with atrial fibrillation (AF) may be at increased risk due to multiple comorbidities. Identifying those predictors of hip fracture in this population is essential for early risk stratification and prevention. Therefore, this study aimed to determine the predictors of hip fracture among patients with AF. Methods This retrospective study included all eligible 189 patients aged ≥50 years with confirmed atrial fibrillation, enrolled using consecutive sampling according to predefined inclusion and exclusion criteria. Demographic and clinical data were collected via a self-designed form. Patients were categorized into fracture and non-fracture groups. Statistical analysis was performed in the Statistical Package for the Social Sciences (SPSS) software, version 25 (Released 2017; IBM Corp., Armonk, New York) using independent t-tests and chi-square tests for group comparisons. Variables with clinical relevance were further analyzed using multivariate logistic regression to identify independent predictors. Results The mean age of participants was 67.60±8.26 years, and 27 (14.28%) patients developed hip fractures. Patients with fractures were significantly older and more likely to be female with lower BMI. Univariate analysis identified multiple significant associations (p<0.05). On further analysis, multivariate logistic regression confirmed age ≥65 years (odds ratio (OR)= 2.32, p=0.037), female gender (OR= 2.14, p=0.047), BMI <22 kg/m² (OR= 2.17, p=0.046), osteoporosis (OR= 4.37, p<0.001), vitamin D deficiency (OR=2.02, p=0.040), history of stroke (OR=2.24 , p=0.047), chronic kideny disease (CKD) (OR=2.12, p=0.048), polypharmacy (OR= 2.82, p=0.012), and prolonged anticoagulation (OR 3.14, p=0.007) as independent predictors. In contrast, smoking, physical inactivity, coronary artery disease, diabetes mellitus, and hypertension, lacked independent association with hip fracture within this population. Conclusion Hip fracture risk in patients with atrial fibrillation is independently associated with several demographic, clinical, and treatment-related factors. Advanced age, female gender, low BMI, osteoporosis, vitamin D deficiency, history of stroke, CKD, polypharmacy, and long-term anticoagulation are key independent predictors. Early identification and targeted management of these factors may help reduce fracture risk in this high-risk population.