Predictors of Mortality in Older Hip Fracture Inpatients Admitted to an Orthogeriatric Unit in Oslo, Norway

• DOI: 10.1177/0898264310378040
• Publication Date: 2010-09-30T03:34:50Z
• Authors: Kristin Holvik; Anette Hylen Ranhoff; Mette Irene Marti...; Ludvig Fjeld Solheim
• Keywords: Aged, 80 and over; Male; Aging; Inpatients; Databases, Factual; Health Services for the Aged; Hip Fractures; Norway; Age Factors; Length of Stay; Body Mass Index; 3. Good health; 03 medical and health sciences; Logistic Models; 0302 clinical medicine; Geriatrics; Confidence Intervals; Health Status Indicators; Humans; Regression Analysis; Female; Mortality; Aged

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.