Background/Purpose: Hip fractures is considered one of the most common and serious injury in the elderly life and have been associated with increased morbidity and mortality. Several risk factors are associated with these elevated rates of mortality, such as the surgical delay, ASA score, type of fracture, gender and comorbidities. The aim of this study was to define risk factors for death one year after hip fracture and in-hospital stay in a public university hospital.

Methods: The study design was a prospective cohort study from April 2005 to April 2011 and it was realized in a tertiary public university hospital. Subjects were followed since the admission until hospital discharge and an appointment was scheduled in one year time. ASA score, gender, fracture type, comorbidities, date of birth, date of admission to hospital and discharge were collected. The statistic analyze was performed using SPSS 18.0. To attribute one year mortality risk factors a Cox’s Regression analyze was performed and to define in-hospital mortality risk factors a Logistic Regression was used. Significant findings was considered those with a p-value=0.05. The survival time was analyzed by Kaplan Meier curves and Long-Rank test was made to identify differences between gender groups, ASA groups and fracture type groups.

Results: 450 patients were initially included on this study. 7.1% lost their follow up. 418 subjects were included in final analysis. Of whom, 4.3% have died in-hospital and 15.3% died at one year time. Female gender represents 76.1% (318) and male corresponds to 23.9% (100). The mean age of patients was 79.82±7.26 years. The mean of time to surgery was 7.1±5.4 days with an IQR (Interquartile Range) from 3-9 days. In-hospital stay mean time was 12.2±11.5 days with and IQR from 6-14 days. The variables that were significant in the univariate Cox’s analyze were time to surgery, ASA score, Ischemic Heart Disease and in-hospital stay. The risk factors to one year mortality were ASA scores and time to surgery. In the Logistic Regression the in hospital death risk factors were ASA score and age. The overall survival time was 330.3±4.6 SE days (Standard Error). Differences in the survival time was observed in ASA groups (between ASA group 1 – ASA I to II – and ASA group 2 – ASA III to V).

Conclusion: ASA score is a useful tool to evaluate the clinical status of patient and to reduce in-hospital and one year mortality. Moreover, surgical delay is a risk factor that has potential to be modified.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/hip-fracture-risk-factors-to-one-year-and-in-hospital-mortality-a-prospective-cohort-in-south-brazil/