Risk Factors and Predictors of In-Hospital Mortality in Geriatric Patients with Hip Fractures: A Retrospective Study

Abstract

Background: Hip fractures are among the most frequent traumatic injuries in the elderly and cause significant morbidity and mortality.  Elderly hip fractures are frequently admitted to the emergency department (ED). 

Aim: This study aimed to evaluate clinically geriatric  patients admitted to an ED with hip fractures and to identify risk factors and predictors for in-hospital mortality. 

Methods: This  retrospective study included patients aged ≥65 years diagnosed with hip fractures in the ED of a tertiary university hospital between  January 1, 2017 and December 31, 2018. A multiple logistic regression model was used to identify risk factors for in-hospital mortality.    

Results: Three hundred and nineteen patients with hip fractures were analyzed, 204 (63.9%) of whom were women, with a mean age of  80.82 ± 7.41 years (65–102 years). In 247 (77.4%) patients, there was at least one comorbidity, most frequently hypertension (52%) or  osteoporosis (51.1%). The median number of drugs used was 5 (range 0 to 9). Intensive care was required in 198 patients (62.1%). The in- hospital mortality rate was 8.5% (27 patients). According to the multiple logistic regression model, the factors predicting in-hospital  mortality were pulse rate [odds ratio (OR), 1.039; 95% confidence interval (CI): 1.002–1.078], total leukocyte count (OR, 0.803; 95% CI:  0.652–0.989), serum calcium level (OR, 0.380; 95% Cl: 0.138–0.912), venous lactate level (OR, 2.459; 95% CI: 1.029–5.878), and length of  hospital stay (OR, 1.205; 95% CI: 1.052–1.381). 

Conclusion: These data suggested that among geriatric hip fracture patients, increased  pulse rate, elevated venous lactate level, low serum calcium level, total leukocyte count at the time of initial presentation to the ED, and  prolonged duration of hospitalization were risk factors for in-hospital mortality.