Factors Associated With Mortality After Surgical Management of Femoral Neck Fractures

J Orthop Trauma. 2020 Nov:34 Suppl 3:S15-S21. doi: 10.1097/BOT.0000000000001937.

Abstract

Background: Hip fractures are recognized as one of the most devastating injuries impacting older adults because of the complications that follow. Mortality rates postsurgery can range from 14% to 58% within one year of fracture. We aimed to identify factors associated with increased risk of mortality within 24 months of a femoral neck fracture in patients aged ≥50 years enrolled in the FAITH and HEALTH trials.

Methods: Two multivariable Cox proportional hazards regressions were used to investigate potential prognostic factors that may be associated with mortality within 90 days and 24 months of hip fracture.

Results: Ninety-one (4.1%) and 304 (13.5%) of 2247 participants died within 90 days and 24 months of suffering a femoral neck fracture, respectively. Older age (P < 0.001), lower body mass index (P = 0.002), American Society of Anesthesiologists (ASA) class III/IV/V (P = 0.004), use of an ambulatory aid before femoral neck fracture (P < 0.001), and kidney disease (P < 0.001) were associated with a higher risk of mortality within 24 months of femoral neck fracture. Older age (P = 0.03), lower body mass index (P = 0.02), use of an ambulatory aid before femoral neck fracture (P < 0.001), and having a comorbidity (P = 0.04) were associated with a higher risk of mortality within 90 days of femoral neck fracture.

Conclusions: Our analysis found that factors that are indicative of a poorer health status were associated with a higher risk of mortality within 24 months of femoral neck fracture. We did not find a difference in treatment methods (internal fixation vs. joint arthroplasty) on the risk of mortality.

Level of evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip*
  • Femoral Neck Fractures* / surgery
  • Fracture Fixation, Internal
  • Hip Fractures* / surgery
  • Humans
  • Retrospective Studies
  • Risk Factors