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Factors associated with one-year mortality of patients admitted with fragility hip fracture: a follow-up study in Southern Sri Lanka

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Abstract

Summary

One hundred and eighty patients with incident fragility hip fracture admitted to a tertiary care center in Sri Lanka were followed up for 12 months. When compared with those survived, patients who died were older and had higher comorbidity and physical impairment, before fracture and at discharge from the hospital.

Introduction

This study examined the factors that are associated with mortality within the first 12 months, of patients admitted with fragility hip fracture to a tertiary care center in Southern Sri Lanka.

Methods

One hundred and eighty consecutive patients admitted with new fragility hip fracture were followed up for 12 months post-fracture. Apart from age and gender, information related to physical dependency (prefracture and at discharge) and comorbidity were collected from all subjects.

Results

Of 180 patients (149women), 107 had surgery while the rest were managed conservatively. Mean (SD) age of study subjects was 76.5 (9.2 years). Thirty-three patients died within the first 12 months were older and had higher comorbidity and physical impairment before fracture and at discharge from the hospital, when compared with those survived. Relative risk (95% CI, p value) of death for being a male was 6.52 (3.18–11.5, < 0.001) and corresponding values for conservative management were 6.59 (2.86–15.2, < 0.001). In the ROC analysis, in which mortality/survival was taken as state variable, AUCs for age, Charlson index, age-adjusted Charlson index, and Barthel index before fracture and Barthel index at discharge were 0.77 (0.04), 0.79 (0.04), 0.70 (0.05), 0.67 (0.05), and 0.76 (0.04 ) (p < 0.01 for all). Age-adjusted odd ratios (95% CI) of ACCI, CCI, surgical management, and Barthel index before fracture and at discharge were 2.21 (1.37 to 3.57), 2.37 (1.46 to 3.83), 0.18 (0.06 to 0.53), 0.91 (0.85 to 0.97), and 0.93 (0.88 to 0.99), respectively (p < 0.05 for all).

Conclusions

We conclude that advanced age, male gender, higher comorbidity, physical impairment before and after fracture, and conservative management lead to a higher risk of mortality in patients admitted with incident fragility hip fracture. This study can be used as a platform for future research in this area in Sri Lanka.

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Funding

This study was supported by the Faculty Research Grant (2016–2017), Faculty of Medicine, University of Ruhuna, Sri Lanka and University Grant Commission (UGC/VC/DRIC/PG2017(1)/RUH/01), Sri Lanka.

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Authors and Affiliations

  1. Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka

    Thilina Abeygunasekara

  2. Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Sarath Lekamwasam

  3. Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Gayani Alwis

  4. Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

    Janaka Lenora

Authors
  1. Thilina Abeygunasekara
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  2. Sarath Lekamwasam
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  3. Gayani Alwis
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  4. Janaka Lenora
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Corresponding author

Correspondence to Sarath Lekamwasam.

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The study received ethical approval from the Ethics Review Committee of the Faculty of Medicine, University of Ruhuna.

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Abeygunasekara, T., Lekamwasam, S., Alwis, G. et al. Factors associated with one-year mortality of patients admitted with fragility hip fracture: a follow-up study in Southern Sri Lanka. Arch Osteoporos 15, 95 (2020). https://doi.org/10.1007/s11657-020-00769-6

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