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Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients

  • Original Article • HIP - FRACTURES
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Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes.


We included 785 patients age 65 years or older, with hip fractures. Operative treatment consisted of external fixation, internal fixation, total hip arthroplasty and hip hemiarthroplasty. Age, gender, type of fracture, type of surgery performed, American Society of Anesthesiology (ASA) grade, clinical comorbidities, anesthesia type, blood transfusion requirement, time to surgery, intensive care unit requirement, operation length and length of hospital stay and number of comorbidities were documented.


During the study period, 785 patients (262 male, 523 female) were included to study, Overall mortality rate was 37.2 % (292/785). Their age ranged between 65 and 100 years (mean 81). Surgery type Kaplan–Meier cumulative mortality curves suggested no significant difference between four different types of surgery groups (p = 0.064). Transfusion requirement was significantly lower in external fixation group comparing to other groups (p = 0.014). Cox regression analysis showed the number of comorbidities 2 and ≥ 3 (p = 0.0027, p = 0.015), transfusion requirement (p = 0.0001), ASA 4 (p = 0.016) to be significant predictors of mortality.


Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.

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This study presented in part as an oral presentation of free paper at the 17th European Federation of National Associations of Orthopaedics and Traumatology Congress, Geneva, Switzerland, June 1–3, 2016.

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Correspondence to Ersin Ercin.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. The authors; Ersin Ercin, Mustafa Gokhan Bilgili, Cihangir Sari, Serdar Hakan Basaran, Bulent Tanriverdi, Erdem Edipoglu, Kurmay Mumtaz Celen, Halil Cetingok and Cemal Kural, declare that they have no conflict of interest.

Ethical approval

Ethics committee approval was received for this study from the local ethics committee of BEAH Clinical Studies. This study did not require informed consent. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Ercin, E., Bilgili, M.G., Sari, C. et al. Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients. Eur J Orthop Surg Traumatol 27, 101–106 (2017).

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