Purpose: The aim of the present study was to explore whether diabetes mellitus (DM) is associated with in-hospital mortality in patients admitted for femur fractures. Methods: Our multicenter case-control study included patients aged ≥65 with a primary diagnosis of femur fracture with and without DM treated in 36 German hospitals between January 2019 and December 2023. Patients with DM were matched to patients without DM (1:3) using propensity scores based on age and sex. Multivariable logistic regression analyses were conducted to assess the associations between DM and in-hospital mortality. Results: A total of 3220 patients with diabetes and 9660 patients without diabetes were included (mean age: 83 years). The overall in-hospital mortality rate was higher in DM patients (6.4%) than in those without DM (5.4%). However, the association between DM and in-hospital mortality was not significant after adjustment for other co-diagnoses. In particular, atrial fibrillation, heart failure, and CKD attenuated the effect of DM on in-hospital mortality. Conclusions: Our data show that DM is not significantly associated with in-hospital mortality in femur fracture patients. However, the presence of other comorbidities may influence mortality outcomes, highlighting the need for early intervention and targeted treatment to improve patient outcomes.
Keywords: Germany; diabetes mellitus; elderly; hip fracture; mortality; risk factor.