Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 5, pp 597–604

Risk factors for complications and in-hospital mortality following hip fractures: a study using the National Trauma Data Bank

  • Philip J. BelmontJr.
  • E’Stephan J. Garcia
  • David Romano
  • Julia O. Bader
  • Kenneth J. Nelson
  • Andrew J. Schoenfeld
Orthopaedic Surgery

DOI: 10.1007/s00402-014-1959-y

Cite this article as:
Belmont, P.J., Garcia, E.J., Romano, D. et al. Arch Orthop Trauma Surg (2014) 134: 597. doi:10.1007/s00402-014-1959-y

Abstract

Study design

Retrospective review of prospectively collected data.

Objective

To describe the impact of patient demographics, injury-specific factors, and medical co-morbidities on outcomes after hip fracture using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB).

Methods

The 2008 NSP-NTDB was queried to identify patients sustaining hip fractures. Patient demographics, co-morbidities, injury-specific factors, and outcomes (including mortality and complications) were recorded and a national estimate model was developed. Unadjusted differences for risk factors were evaluated using t test/Wald Chi square analyses. Weighted logistic regression and sensitivity analyses were performed to control for all factors in the model.

Results

The weighted sample contained 44,419 incidents of hip fracture. The average age was 72.7. Sixty-two percent of the population was female and 80 % was white. The mortality rate was 4.5 % and 12.5 % sustained at least one complication. Seventeen percent of patients who sustained at least one complication died. Dialysis, presenting in shock, cardiac disease, male sex, and ISS were significant predictors of mortality, while dialysis, obesity, cardiac disease, diabetes, and a procedure delay of ≥2 days influenced complications. The major potential modifiable risk factor appears to be time to procedure, which had a significant impact on complications.

Conclusions

This is the first study to postulate predictors of morbidity and mortality following hip fracture in a US national model. While many co-morbidities appear to be influential in predicting outcome, some of the more significant factors include the presence of shock, dialysis, obesity, and time to surgery.

Level of evidence

Prognostic study, Level II.

Keywords

Hip fractureMortalityComplications

Copyright information

© Springer-Verlag Berlin Heidelberg (outside the USA) 2014

Authors and Affiliations

  • Philip J. BelmontJr.
    • 1
  • E’Stephan J. Garcia
    • 1
  • David Romano
    • 1
  • Julia O. Bader
    • 2
  • Kenneth J. Nelson
    • 1
  • Andrew J. Schoenfeld
    • 3
  1. 1.Department of Orthopaedic Surgery, William Beaumont Army Medical CenterTexas Tech University Health Sciences CenterEl PasoUSA
  2. 2.Statistical Consulting LaboratoryUniversity of Texas at El PasoEl PasoUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of MichiganAnn ArborUSA