Changes in hip fracture incidence, mortality and length of stay over the last decade in an Australian major trauma centre
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The aim of this study was to describe the population-based longitudinal trends in incidence, 30-day mortality and length of stay of hip fracture patients in a tertiary referral trauma centre in Newcastle, New South Wales, Australia, and identify the factors associated with increased 30-day mortality.
A retrospective database and chart review was conducted to patients aged ≥65 years with a diagnosis of femoral neck or pertrochanteric fracture admitted to the John Hunter Hospital between 01 January 2002 and 30 December 2011. The main outcome measure was 30-day mortality; secondary outcome was acute length of stay.
There were 4,269 eligible patients (427 ± 20 per year) with hip fractures over the 10-year study period. The absolute incidence increased slightly (p = 0.1) but the age-adjusted rate decreased (p ≤ 0.0001). The average age (83.5 ± 7.1 years) and percentage of females (73.7 %) did not change. Length of stay increased by a factor of 2.5 % per year (p < 0.0001). Thirty-day mortality decreased from 12.3 % in 2002 to 8.20 % in 2011 (p = 0.0008). Independent risk factors associated with increased 30-day mortality were longer admissions (p < 0.0001), increased age (p = 0.005), dementia (p = 0.01), male gender (p < 0.0001), higher American Society of Anaesthesiologists score (p < 0.0001), and longer time to operating theatre (p = 0.002).
Despite the relative ageing of our population, a decrease in the age-standardised rate of fractured hip in elderly patients has seen the number of admissions remain unchanged in our institution from 2002 to 2011. There was a decrease in 30-day mortality, while length of stay increased.
KeywordsHip fracture Geriatric fractures Fragility fractures Low-energy falls
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