Hip fracture and mortality: study of specific causes of death and risk factors

Abstract

Summary

The leading causes of mortality in our study were pneumonia, diseases of the circulatory system, and dementias. In patients with hip fractures, the emphasis should be placed not only on measures to prevent falls and osteoporosis, but also on preventing functional decline and pneumonia.

Purpose

To describe the specific causes of death in patients who died up to 2 years after sustaining a hip fracture, how many of those deaths were directly related to the hip fracture, and the risk factors for mortality.

Methods

A retrospective review of the clinical data of all patients admitted with hip fractures between December 2009 and September 2015. Cause of death was classified according to the International Statistical Classification of Diseases and Related Health Problems (ICD10)

Results

In the first 2 years after hip fracture, 911 patients (32.7%) died. The leading causes of mortality were pneumonia 177 (19.4%), diseases of the circulatory system 146 (16%), and dementias 126 (13.9%). Thirty patients (3.2%) died from causes directly related to hip fracture or surgery. Mortality risk factors with a higher relative risk were advanced age, male sex, higher comorbidity, delirium, and medical complications during admission.

Conclusions

Pneumonia and circulatory system diseases were the commonest causes of death in our study. In patients with hip fractures, emphasis should be placed on preventing functional decline and pneumonia. In a few patients, death was directly related to the hip fracture, although decompensation of chronic illness as a result of hip fracture and fracture-related functional decline may have been indirect causes. Patients with worse conditions at admission had the highest risk of mortality.

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Acknowledgments

We would like to thank Janet Gaynor Dawson for her help with the English in this paper and Ignasi Gich for his statistical assessment.

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Correspondence to Montserrat Barceló.

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The study was approved by the institutional ethics committee (IIBSP-FEM-2018-18). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Barceló, M., Torres, O.H., Mascaró, J. et al. Hip fracture and mortality: study of specific causes of death and risk factors. Arch Osteoporos 16, 15 (2021). https://doi.org/10.1007/s11657-020-00873-7

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Keywords

  • Hip fracture
  • Cause of death
  • Mortality
  • Mortality risk factors