Hip fracture in centenarians, what can we expect?

INTRODUCTION

Hip fractures in centenarians are rising due to the increase in life expectancy. The objective of this study is to compare the characteristics of centenarians' hip fracture with a younger control group, and to analyze whether there are differences in terms of in-hospital mortality, complications, and short-medium-term survival between them.

MATERIAL AND METHODS

Retrospective case-control study, with a series of 24 centenarians and 48 octogenarians with a hip fracture. Comorbidities and Charlson index, surgical delay, complications and mortality during admission, and hospital stay were analyzed. At discharge, early mortality, survival after one year, and return to previous functionality were assessed.

RESULTS

No significant differences were found in baseline parameters or comorbidities (P>.05), and the type of was a woman with an extracapsular fracture. Hospital stay was longer in the control group (P=.038), and the most frequent complication was anemia requiring transfusion (23/24 in centenarians, P<.0001). In-hospital mortality and accumulated at one year in the centenarians was 33 and 67%, respectively, compared to 10 and 25% in the octogenarians (P=.017, OR=4.3 [1,224-15,101] and P=.110). Only 2 centenarian patients were able to walk again after the intervention, while in the control group 53.84% returned to the previous functional situation (P=.003).

CONCLUSIONS

Compared to a control group of younger patients, in-hospital mortality and in the first year after a hip fracture is significantly higher in centenarians, and very few recover activity prior to the fracture.