Long-term survival outcome of patients with femoral neck and trochanteric fractures: A nationwide population-based observational study

Background: Hip fractures in the geriatric population are the significant medical and public health concern due to their adverse outcomes and high mortality. The purposes of the study were to compare the survival between trochanteric and femoral neck hip fracture on older patients and further compare the difference and prognosis in this population. Methods: Data were extracted from the Taiwanese National Health Insurance Research Database. A retrospective cohort study was conducted to analyze regarding patients >= 65 years who sustained a fragile hip fracture. Risk factors that had the potential to confound the correlation between hip fracture and mortality were recorded. Univariate analysis using the Cox proportional hazards model was performed to compute the unadjusted hazard ratios of each covariate for excess mortality. Subsequently, covariates that were significant in the univariate analysis were included in a multivariate model. Results: A total of 61,346 patients were included nationwide. The femoral neck fracture population were significantly younger, have lower Charlson comorbidity index score, with less proportion to have comorbidities. The mortality rate was lower for femoral neck fracture patients compared to trochanteric fracture patients. Hazard ratios for trochanteric patients were 1.32, 0.96, 1.02 and 1.09 for 0-3 months, 3 months-1 year, 1-5 years and 5-10 years. Conclusion: The trochanteric fracture group showed a noticeably higher rate of mortality compared to the femoral neck fracture group in the first 3 months after injury. This suggests the need for extra careful postoperative care for individuals in the trochanteric fracture group. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).