Long-term survival and probability of death due to fragility hip fracture in patients over 65 years of age: a retrospective cohort study.

UNLABELLED

Fragility hip fractures significantly impact long-term survival in patients over 65 years. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. Advanced age, male sex, and cognitive/functional impairment increased mortality. Comprehensive assessments are essential for personalized treatment.

PURPOSE

Fragility hip fractures are increasing due to population aging. The main objective of this study was to determine long-term survival and the probability of dying from hip fracture or from other causes in patients over 65 years old who underwent surgery for a fragility hip fracture.

METHODS

A retrospective cohort study was conducted between June 2010 and December 2021. The main outcomes were overall survival, relative survival, and the probability of dying either from hip fracture or from other causes at 1, 5, and 10 years after surgery determined with the WebSurvCa application.

RESULTS

A total of 2646 patients were included with a median age of 86.3 years [81.7-90.3]; 75% were women. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. The cumulative probability of dying from a hip fracture was 17.2%, 35.4%, and 49.4% at 1, 5, and 10 years, respectively. Factors such as advanced age, male sex, and prior functional or cognitive deterioration were associated with worse long-term survival. In patients over 85 years old, without functional dependence or with normal cognitive status, the probability of dying from other causes at 5 and 10 years exceeded that of dying from the hip fracture.

CONCLUSION

Our results highlight that long-term mortality in these patients is high, persisting even 10 years after the fracture. Comprehensive evaluation considering age, functional, and cognitive status is essential in order to predict outcomes and personalize treatment strategies.