Why the study?
Hip fractures cause devastating complications in older adults, with postsurgery mortality reaching up to 58% within one year, prompting an investigation into prognostic factors for mortality.
What factors are associated with increased risk of mortality within 24 months of surgical management for a femoral neck fracture in patients aged ≥50 years?
What factors are associated with increased risk of mortality within 24 months of surgical management for a femoral neck fracture in patients aged ≥50 years?
Factors indicative of poorer baseline health status, such as older age, lower BMI, and kidney disease, are associated with higher mortality up to 24 months after surgical management of femoral neck fractures.
Answers are grounded in this paper and cite their sources.
Poorer baseline health status signals higher 24-month mortality risk after femoral neck fracture; leaves open need for validation and targeted interventions in prospective studies.
BACKGROUND: Hip fractures are recognized as one of the most devastating injuries impacting older adults because of the complications that follow. Mortality rates postsurgery can range from 14% to 58% within one year of fracture. We aimed to identify factors associated with increased risk of mortality within 24 months of a femoral neck fracture in patients aged ≥50 years enrolled in the FAITH and HEALTH trials. METHODS: Two multivariable Cox proportional hazards regressions were used to investigate potential prognostic factors that may be associated with mortality within 90 days and 24 months of hip fracture. RESULTS: Ninety-one (4.1%) and 304 (13.5%) of 2247 participants died within 90 days and 24 months of suffering a femoral neck fracture, respectively. Older age (P < 0.001), lower body mass index (P = 0.002), American Society of Anesthesiologists (ASA) class III/IV/V (P = 0.004), use of an ambulatory aid before femoral neck fracture (P < 0.001), and kidney disease (P < 0.001) were associated with a higher risk of mortality within 24 months of femoral neck fracture. Older age (P = 0.03), lower body mass index (P = 0.02), use of an ambulatory aid before femoral neck fracture (P < 0.001), and having a comorbidity (P = 0.04) were associated with a higher risk of mortality within 90 days of femoral neck fracture. CONCLUSIONS: Our analysis found that factors that are indicative of a poorer health status were associated with a higher risk of mortality within 24 months of femoral neck fracture. We did not find a difference in treatment methods (internal fixation vs. joint arthroplasty) on the risk of mortality. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Bzovsky et al. (2020) studied this question.
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