Objective: To find out which factors influence outcome after a fractured hip, so that the optimum treatment may be chosen for each patient.
Design: Prospective cohort study.
Setting: 3 teaching and 2 rural hospitals, The Netherlands.
Subjects: 215 patients aged 55-102 years (median 82) who presented with a fractured hip during 1994.
Interventions: Interviews shortly after the injury and 4 and 12 months later, study of radiographs, and evaluation of casenotes.
Main outcome measures: Mobility and functional recovery.
Results: 38 patients had died by the 4-month follow up, at which time 64/177 (36%) had regained the level of mobility that they had before the injury. At 12 months the figure was 58/148 (39%). The corresponding figures for functional recovery were 52/177 (29%) and 36/148 (24%). Factors that militated against recovery were increasing age, coexisting diseases, general complications and local complications.
Conclusions: The chance of a patient with a hip fracture making any further recovery after 4 months is minimal. Local complications are the most important risk factor.