Comorbidity as a predictor of mortality and mobility after hip fracture

Geriatr Gerontol Int. 2016 May;16(5):561-9. doi: 10.1111/ggi.12510. Epub 2015 May 15.

Abstract

Aim: To determine mortality and mobility rates after hip fracture.

Methods: A prospective study (n = 199 patients) was carried out in the Health Care Center of A Coruña (Spain) during the period between January 2009 and December 2011. A descriptive study, and Cox and logistic regression analysis were carried out. Informed consent and ethical review board approval were obtained (code 2010/120 CEIC Galicia).

Results: The patients' mean age was 82.5 ± 8.4 years and 76% were female. The average Charlson Comorbidity Index score was 6.1 ± 2.1. Creatinine clearance <60 mL/min/1.73 m(2) was 44%. The probability of survival 6 months after hip fracture was 89.2% and the survival rate at 12 months was 81.4%. Cox regression analysis showed that the indicator that most influenced mortality rate was comorbidity (HR = 1.133; P = 0.020) and age approaching borderline statistical significance (HR = 1.034; P = 0.064). The Parker Mobility Score decreased significantly (P < 0.001) after hip fracture. Before fracture, 19% of the patients were able to get about the house, 26% were able to get out of the house and 55% were able to go shopping. After hip fracture (90 days), the percentages changed to 56.2%, 19.1% and 24.7%, respectively (P < 0.001). After taking into account age, sex, type of fracture, surgical delay, previous fracture and comorbidity, the only indicator capable of predicting incapacity to walk was comorbidity.

Conclusions: Comorbidity is the best predictor of mortality and mobility after hip fracture. Geriatr Gerontol Int 2016; 16: 561-569.

Keywords: hip fractures; hip replacement; mobility; mortality; recovery of function.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip
  • Female
  • Follow-Up Studies
  • Fracture Fixation
  • Hip Fractures / complications*
  • Hip Fractures / mortality*
  • Hip Fractures / surgery
  • Humans
  • Male
  • Prospective Studies
  • Recovery of Function
  • Regression Analysis
  • Spain
  • Survival Rate
  • Walking / physiology*