Predictors and Outcome of Fragility Hip Fracture: A Prospective Study from North India

INTRODUCTION: Fragility hip fracture is a useful surrogate marker of the burden of osteoporosis. With improving life expectancy and progressive ageing of population, the global burden of osteoporotic fracture is increasing. Despite this, there is paucity of data regarding epidemiology, predictors, and outcomes of fragility hip fractures in the Indian population. METHODS: In this multicenter, prospective observational study, 264 patients of fragility hip fracture were followed up for 12 months. RESULTS: Men (46.2%) and women (53.8%) had a nearly equal distribution of fragility hip fracture. Mean (±SD) age of study population was 65.9 ± 12.6 years and men had earlier age (64.7 ± 12.6 years) of fracture as compared to women (66.9 ± 12.6 years). Out of these, 89.7% patients had osteoporosis, 7.6% had osteopenia, and 2.7% patients had normal bone mineral density (BMD). Fractures predominantly occurred inside the home (229, 86.7%) as compared to outside (35, 13.3%). Female gender, hypertension, diabetes, anemia, smoking, and alcohol were associated with lower BMD, but not a predictor of morbidity. Aging (P = 0.000), osteoporosis (P = 0.012), and diabetes (P = 0.008) were predictors of increased mortality. A total of 243 (92%) patients underwent surgery with a mean hospital stay of 13.5 ± 2.9 days and 34 (12.9%) patients died. Maximum death (73.5%) occurred in first 3 months and the commonest cause of death was cardiovascular (44.1%) related. CONCLUSION: The majority of fragility hip fractures occurred inside the home. Distribution of fractures in either gender is comparable. Aging, osteoporosis, and diabetes are predictors of poor outcome. We recommend development of newer strategies that target male as well as female patients with osteoporosis with particular attention to prevent in-house falls and fractures.