• Simon Kwoon-Ho Chow, Jiang-Hui Qin, Ronald Man-Yeung Wong, Wai-Fan Yuen, Wai-Kit Ngai, Ning Tang, Chor-Yin Lam, Tak-Wing Lau, Kin-Bong Lee, Kwai Ming Siu, Sze-Hung Wong, Tracy Y Zhu, Wing-Hoi Cheung, and Kwok-Sui Leung.
• Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 5/F, Clinical Sciences Building, Shatin, New Territories, Hong Kong, SAR, China.
• J Orthop Surg Res. 2018 Sep 14; 13 (1): 235.

BackgroundThe purpose of this registry-based retrospective study was to investigate the risk factors related to one-year mortality in displaced intracapsular fragility hip fracture patients.MethodsPatients were screened from the Fragility Fracture Registry. Inclusion criterion was displaced intracapsular hip fracture patients with atypical or pathological fractures excluded. One-year mortality was investigated against risk factors including age, gender, past medical history, pre-fracture mobility (PFM), pre-operation ASA grade, delayed surgery over 48 h, post-surgical complications, and length of stay at acute orthopedic ward (LOS).ResultsA total of 1050 patients were included for further analysis. Gross one-year mortality was 14.9%. One-year mortality was significantly higher in patients who received non-operative treatment and those who received surgery but delayed over 48 h after admission (both p <  0.001). Male gender (OR = 2.708), advanced age (OR = 1.359), higher risk ASA grades (III to V) (OR = 1.990), past history of gastrointestinal disease (OR = 1.671), and renal impairment (OR = 1.984) were related to higher one-year mortality. The mortality of patients in PFM grade 3 and LOS group 3 was significantly higher (OR = 2.240 and 1.722, respectively).ConclusionsHigher age, male gender, past gastrointestinal disease and renal impairment, ASA grade over 3, indoor confined pre-fracture ambulatory, and stay at hospital over 15 days were risk factors related to higher one-year mortality in surgically treated displaced intracapsular hip fracture patients. A multi-disciplinary approach is advised to patients identified with these risks factors and co-managed by orthopedic surgeons, geriatricians, and fracture liaison nurses.

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