Functional outcome and short-term mortality after surgery for hip fractures

Introduction Hip fractures are associated with significant disability and mortality. We conducted a prospective study to investigate the mortality rate and functional ability in patients who underwent surgery for hip fracture over a one-year period. Materials and methods One-hundred patients (72 females and 28 males; mean age, 78.2 years (range 32–102) surgically treated for hip fracture were prospectively followed-up for 1 year. Fifty-five and 45 patients sustained a trochanteric fracture or a fracture of the femoral neck, respectively. Daily-life activities (ADL scale), cognitive impairment (MMSE Scale), comorbidity (CIRS scale), functional status, and personal mobility were prospectively evaluated 4 months and 1 year after the operation by telephonic interviews with the patient, his/her relatives, or primary care providers. Mortality data was also recorded. Possible outcome predictors were evaluated by regression analysis. Results The overall mortality rate at 1 year was 19 percent. Male sex, comorbidity, and a poor pre-fracture functional status were significant predictors of mortality. ADL scale and personal mobility significantly improved between 4-month and 1-year follow-up controls. Forty-five percent of patients without preoperative walking limitations dropped out their walking aids 1-year postoperatively. Patients with trochanteric fracture treated with hip prosthesis showed greater and faster postoperative functional improvement with respect to patients treated by gamma nail. Discussion Current results represent the first report of a wider ongoing prospective study aimed to evaluate possible outcome predictors of hip fractures to be used to improve and personalize the surgical treatment. The preoperative functional status and comorbidities are major determinants of 4-month and 1-year postoperative mortality and ability of subjects. Conclusions Our preliminary findings demonstrate the role of surgery in promoting the functional improvement of patients who sustained hip fracture