Predictors of mortality in older hip fracture inpatients admitted to an orthogeriatric unit in oslo, norway.

OBJECTIVES

To identify to which degree patient-related factors (age, gender, place of residence, general health condition, comorbidity) and hospital-related factors (waiting time for surgery, type of surgery, in-hospital complications, length of stay) may predict 1-year mortality in elderly hip fracture patients in an orthogeriatric unit, to optimize treatment and care.

METHOD

In-hospital patient information was routinely collected by multidisciplinary staff and entered into a database. Information about mortality was obtained for 567 patients aged 65 and above. Multivariate logistic regression was performed.

RESULTS

Overall mortality was 23.5%, but there was a large variation in mortality according to age, gender, comorbidity, and place of residence. Independent predictors of mortality were admittance from nursing home (risk ratio [RR] = 3.24, 95% confidence interval [CI] = 2.37-4.43 compared with home dwellers) and a higher American Society of Anesthesiologists (ASA) score (RR = 1.75 and 95% CI = 1.24-2.46, for ASA ≥ 3 compared with ASA ≤ 2). Male gender, increasing age, increasing number of comorbid conditions, and having fallen indoors were indicators, but not independent predictors, of higher mortality.

DISCUSSION

Almost one fourth of older hip fracture patients in this unit died within a year. The most important predictor was admittance from nursing home, which was associated with comorbidity and frailty. More attention to patients from nursing homes is needed in the health care system.