Risk factor analysis for in-hospital death of geriatric hip fracture patients

OBJECTIVES: To investigate the risk factors of perioperative in-hospital death in elderly patients with hip fracture and the applicability of risk assessment tools. METHODS: Thirteen in-hospital death cases from 1878 geriatric hip fracture treated in Jishuitan Hospital, China from May 2015 to December 2017 were collected, each dead patient was compared with 4 normal discharged patients with a postoperative survival of more than 90 days at the same admission time (within 2 weeks), gender, age (±5 years), and fracture type. Binary logistic regression was used to analyze the risk factors of in-hospital death; Hosmer-lemeshow goodness of fit test was used to evaluate the goodness of fit of E-PASS (estimation of physical ability and surgical stress) and NHFS (Nottingham hip fracture score). RESULTS: Mortality in hospital was 0.7%; the number of comorbidities and the time from fracture to operation were the risk factors of in-hospital death. Nottingham hip fracture score system is more accurate to elderly hip fractures in China. CONCLUSION: Early operation is the key factor to reduce mortality in elderly patients with hip fracture, and the comorbidities in the basic state of the elderly are the independent risk factors of death; NHFS is recommended to estimate death risk in geriatric hip fractures.