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Mobility and mortality outcomes among older individuals with hip fractures at a teaching hospital in Malaysia

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Abstract 

Summary

The challenges of hip fracture care in Malaysia is scarcely discussed. This study evaluated the outcomes of older patients with hip fracture admitted to a teaching hospital in Malaysia. We found that one in five individuals was no longer alive at one year after surgery. Three out of five patients did not recover to their pre-fracture mobility status 6 months following hip fracture surgery.

Purpose

With the rising number of older people in Malaysia, it is envisaged that the number of fragility hip fractures would also increase. The objective of this study was to determine patient characteristics and long-term outcomes of hip fracture in older individuals at a teaching hospital in Malaysia.

Methods

This was a prospective observational study which included consecutive patients aged  ≥ 65 years old admitted to the orthopedic ward with acute hip fractures between March 2016 and August 2018. Patient socio-demographic details, comorbidities, pre-fracture mobility status, fracture type, operation and anesthesia procedure, and length of stay were recorded. Post-fracture mobility status was identified at 6 months. Cox proportional hazard analysis was used to assess the risk of death in all patients.

Results

310 patients (70% women) with the mean age of 79.89 years (SD 7.24) were recruited during the study period. Of these, 284 patients (91.6%) underwent surgical intervention with a median time to surgery of 5 days (IQR 3–8) days. 60.4% of patients who underwent hip fracture surgery did not recover to their pre-fracture mobility status. One year mortality rate was 20.1% post hip fracture surgery. The independent predictor of mortality included advanced age (hazard ratio, HR = 1.05, 95% CI = 1.01–1.08; p = 0.01), dependency on activities of daily living (HR = 2.08, 95% CI = 1.26–3.45; p = 0.01), and longer length of hospitalization (HR = 1.02, 95% CI = 1.01–1.04; p < 0.01).

Conclusion

One in 5 individuals who underwent hip fracture surgery at a teaching hospital in Kuala Lumpur was no longer alive at one year. A systematic approach to hip fracture management is crucial to improve outcomes and restore pre-fracture function of this vulnerable group of patients.

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Acknowledgements

The authors are grateful to our research assistants Aun Yi Yang and Laila Bilqish for assisting in the data collection.

Funding

The study was funded by the University of Malaya Bantuan Kecil Penyelidikan (BK022-2016) research grant.

All authors declare that the manuscript has not been submitted to other journals for consideration of publication. The manuscript has also not been published previously.

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Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Hui Min Khor, Maw Pin Tan, Kit Mun Tan, Nor’Izzati Binti Saedon, Terence Ong, Ai-Vyrn Chin, Shahrul Bahyah Kamaruzzaman & Kejal Hasmukharay

  2. Academic Unit Trauma and Emergency, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    Mohd Idzwan bin Zakaria

  3. Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

    C. Sankara Kumar & Simmrat Singh

  4. Department of Medicine, Hospital Sultan Ismail, Jalan Mutiara Emas Utama, Taman Mount Austin, Johor Bahru, Johor, Malaysia

    Hui Xin Teh

  5. Department of Medicine, Hospital Seberang Jaya, Jalan Tun Hussein Onn, Seberang Jaya, Permatang Pauh, Pulau Pinang, Malaysia

    Fang Chin Tan

  6. Parkcity Medical Centre, No. 2, Jalan Intisari Perdana, Desa Parkcity, Kuala Lumpur, Malaysia

    Poh Yong Chong

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  1. Hui Min Khor
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Correspondence to Hui Min Khor.

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Khor, H.M., Tan, M.P., Kumar, C.S. et al. Mobility and mortality outcomes among older individuals with hip fractures at a teaching hospital in Malaysia. Arch Osteoporos 17, 151 (2022). https://doi.org/10.1007/s11657-022-01183-w

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