Hip Fractures Type and Other Demographic, Medical and Surgical Factors as Predictors of One Year Mortality and Mobility

The objective of this study was to assess the impact of several fracture related and surgical factors on mortality and mobility one year after a hip fracture. These factors include fracture pattern, type of surgery, major surgical complications and sequential fractures. A second objective was to identify other demographic and medical predictors of mortality and mobility status.

We reviewed our prospectively collected, institutional hip fracture registry for all 765 hip fracture surgeries performed between January 2014 and December 2015. Patients with incomplete data, younger than 60 and pathologic and periprosthetic fractures were excluded. Mobility status analysis was performed for patients that survived the first year and could walk outdoors freely or with a cane before the fracture. Fractures were classified as pertrochanteric stale, pertrochanteric unstable, reverse obliquity, subtrochanteric, atypical, undisplaced intracapsular and displaced intracapsular fractures. Mobility status was classified as 1 - freely mobile without aids; 2 - mobile outdoors with a cane; 3 - mobile outdoors with a walker; 4 - no functional mobility or limited indoor mobility, and the change between the preinjury and 1 year postoperative mobility status was calculated.

Unadjusted analysis found hemiarthroplasty, higher age, male gender, lowere mental score, higher ASA score and lesser preinjury mobility status to be predictors of mortality and intracapsular fractures, total hip arthroplasty, lower age, lower ASA scores and better mental scores to be predictors of higher mobility status. However, after multinomial logistic regression analysis, only age, gender and mental scores persisted as predictors of mortality and only mental scores persisted as a predictor of mobility status.

The mere event of a hip fracture, together with the preinjury functional, mental and medical condition are the prime determinants of patients` prognosis, in relation to both early and one year mortality, and to the probability of regaining the previous ability to ambulate.