National 5-year data analysis of health outcomes in hospitalized geriatric patients with hip fracture.

BACKGROUND

Increasing awareness about fall prevention and osteoporosis screening could reduce the incidence of hip fractures in the elderly, and comprehensive care can improve outcomes. There is limited nationwide data on the health outcomes of hip fractures when comparing operative and non-operative approaches. The study objectives were to ascertain the short-term outcomes of older patients hospitalized with hip fractures and to elucidate the variables correlated with in-hospital mortality.

METHODS

This study utilized a retrospective dataset comprising hospitalized individuals aged ≥60 years who were admitted due to hip fractures during the fiscal years spanning from 2019 to 2023. The National Health Security Office conducted the diagnosis, employing the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM) code S72. Surgical procedures pertinent to hip fractures were categorized under ICD-9-79.1, ICD-9-79.3, ICD-9-81.51, ICD-9-81.52, and ICD-9-81.53. Demographic information was analyzed through descriptive statistical methods. Factors associated with in-hospital mortality were assessed through both univariate and multivariate analyses.

RESULTS

Out of 115,333 diagnosed cases, the admission rate was 205.5 per 100,000 population, with 46.9 % undergoing surgery. The overall in-hospital mortality rate was 4.04 per 100,000 individuals. Patients who underwent surgery showed a lower in-hospital mortality rate compared to those who did not, recorded at 1.3 vs 1.9 (p < 0.05) for males and 2.1 vs 2.6 (p < 0.05) for females per 100,000 population. Outcomes at discharge for those receiving operative versus non-operative treatment revealed a mean length of stay (LOS) of 11.5 versus 10.8 days (p < 0.05), mean healthcare costs of $1973 versus $1554 (p < 0.05), and in-hospital mortality rates of 1.8 % versus 2.1 % (p < 0.05). Factors increasing mortality included age (70-80 years: OR 1.51, 95 %CI 1.30-1.74; ≥80 years: OR 2.59, 95 %CI 2.27-2.97), male gender: OR 1.69, 95 %CI 1.55-1.85, extracapsular fracture: OR 1.15, 95 %CI 1.05-1.25, and a LOS ≥10 days: OR 1.63, 95 %CI 1.49-1.78. Surgery associated with lower mortality: OR 0.88, 95 %CI 0.81-0.96.

CONCLUSION

Hip fracture patients who underwent surgery had better mortality outcomes than those who did not. Less than half of patients opted for surgery in the past five years. Therefore, it is essential to encourage surgical treatment for these patients.