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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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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DOI: https://doi.org/10.1007/s11657-022-01183-w