Clinical and Demographic Characteristics of Centenarians versus Other Age Groups Over 75 Years with Hip Fractures

Clin Interv Aging. 2023 Mar 22:18:441-451. doi: 10.2147/CIA.S386563. eCollection 2023.

Abstract

Objective: The primary objective was to describe the clinical characteristics, management, and outcomes of centenarians with fragility hip fracture and compare them to other age groups. The secondary objective was to determine the variables associated with length of stay, in-hospital mortality and 30-day mortality.

Materials and methods: This is a secondary analysis of the Spanish National Hip Fracture Registry. We included patients ≥75 years admitted for fragility hip fractures in 86 Spanish hospitals between 2017 and 2019, dividing the sample into four age groups. The variables studied were baseline characteristics, type of fracture, management, length of stay, in-hospital mortality and 30-day mortality.

Results: We included 25,938 patients (2888 were 75-79 years old; 14,762 octogenarians; 8,035 nonagenarians and 253 centenarians). Of the centenarians, 83% were women, 33% had severe dementia, 9% had severe dependency and 36% lived in residential care homes. Six out of ten had intertrochanteric fracture. Length of hospital stay was 8.6 days; in-hospital mortality was 10.3% and 30-day mortality 20.9%. Older age groups had more women, severe functional dependency, severe dementia, intertrochanteric fracture, living in care facilities and being discharged to nursing care. They had less frequent early mobilization, osteoporosis treatment and discharge to rehabilitation units. In-hospital and 30-day mortality were higher with increasing age. In centenarians, time to surgery >48 hours was independently associated with length of stay (correlation coefficient 3.99 [95% CI: 2.35-5.64; p<0.001]) and anaesthetic risk, based on an ASA score of V, was related to 30-day mortality (ASA score II [OR 0.25, 95% CI: 0.09-0.70; p=0.009] and ASA score III [OR 0.43, 95% CI: 0.19-0.96; p=0.039]).

Conclusion: Centenarians had different clinical characteristics, management and outcomes. Although centenarians had worse outcomes, nearly 4 out of 5 centenarians were alive one month after surgery.

Keywords: ASA grade; centenarians; fracture; mortality; registry.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Centenarians*
  • Demography
  • Female
  • Hip Fractures* / epidemiology
  • Hip Fractures* / surgery
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Retrospective Studies

Grants and funding

This study was funded by AMGEN SA, UCB Pharma, Abbott Laboratories and FAES Farma; two research grants awarded by Fundación Mutua Madrileña (grant number AP169672018) and Fundación Mapfre and research grants from the spanish government: Proyecto de investigaci’ón en Salud del ISC III (AS2020) PI 20/00158. The sponsors were not involved in any aspect of the project or in the preparation of the manuscript.