Archives of Osteoporosis

, 8:150 | Cite as

Changes in hip fracture incidence, mortality and length of stay over the last decade in an Australian major trauma centre

  • Nicole Williams
  • Ben M. Hardy
  • Seth Tarrant
  • Natalie Enninghorst
  • John Attia
  • Christopher Oldmeadow
  • Zsolt J. Balogh
Original Article

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Hip fracture Geriatric fractures Fragility fractures Low-energy falls 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • Nicole Williams
    • 1
  • Ben M. Hardy
    • 2
  • Seth Tarrant
    • 3
  • Natalie Enninghorst
    • 4
  • John Attia
    • 5
  • Christopher Oldmeadow
    • 2
  • Zsolt J. Balogh
    • 6
  1. 1.Orthopaedics and TraumaWomen’s and Children’s Hospital and University of AdelaideAdelaideAustralia
  2. 2.School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
  3. 3.Department of Orthopaedic SurgeryJohn Hunter HospitalNewcastleAustralia
  4. 4.Department of TraumatologyJohn Hunter HospitalNewcastleAustralia
  5. 5.School of Medicine and Public Health and Department of MedicineUniversity of Newcastle and John Hunter HospitalNewcastleAustralia
  6. 6.Department of TraumatologyJohn Hunter Hospital and University of NewcastleNewcastleAustralia

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