Mortality and Function After Hip Fractures in Different Ethnic Population Groups in Israel

The most significant factors affecting the risks of mortality and functional decrease are patient related and include age, gender, co-morbidities and mental status. Several studies demonstrated ethnic disparities in incidence, mortality and functional outcome after hip fractures in the United States. The objective of this study was to assess the relationship between ethnicity and hip fracture incidence and outcomes, including mortality and function and complications in Israel.

We reviewed our prospectively collected, institutional hip fracture registry for all patients admitted between January 2014 and December 2015. Patients with incomplete data, younger than 60 years of age, pathologic and periprosthetic fractures were excluded. 693 patients were included in the study. Ethnicity was determined based on country of birth and for Israeli born on nationality (Jewish or Arab). Complications, mortality and mobility status at one year follow-up were recorded. 27130 patients admitted to the internal medicine and surgical wards served as a control group for ethnic distribution.

Immigrants from Europe and America had a significantly higher incidence of hip fractures than the other groups. Fracture type had significant differences between groups with more than 70% extracapsular fractures in Arabs and immigrants from eastern countries, and only 60% extracapsular fractures in immigrants from the west and the former Soviet union. Mortality, complication rate and outdoor ambulation at 1 year were similar in all ethnic groups.

Not much is known about the influence of ethnicity on the incidence and outcome of hip fractures outside the US. Our study demonstrated a few differences in the incidence and characteristics of fractures between groups, but no difference in outcome. These findings were different than the mostly North American literature available.