Patients aged ninety years and older are exposed to increased risk of one-year mortality after hip fractures

BackgroundThe increase in the population over 90 years old suggests an expected surge in the number of extreme elderly patients sustaining hip fractures.ObjectiveThe aim of this study is to identify factors associated with 1-year mortality and determine the conditions that are associated with an unfavorable survival outcome in nonagenarians.DesignCross-sectional studySubjectsNonagenarian patients presenting with hip fractures between 2013 and 2018.MethodsBivariate and multivariate analyses were performed to identify variables associated with mortality, and a survival analysis was conducted to determine whether the Charlson Comorbidity Index (CCI) is associated with mortality.ResultsA total of 127 patients, with a mean age of 92.84 years was assessed, identifying 1-year mortality rate in 53.5% of patients. According to the bivariate analysis, requirement of postoperative vasopressor support, transfusion, decompensated heart failure and general anesthesia were associated with a higher probability of 1-year mortality after surgery. Body mass index, health status, dementia or CCI >= 3 were not associated with mortality. Similarly, the Kaplan-Meier survival analysis showed no difference in mortality rate of patients with CCI >= 3 (p=0.282).ConclusionPatients older than 90 years with hip fractures have higher mortality rates per year than younger patients. Some associations were found, but more studies are needed to reach final conclusions, which could help identify higher-risk patients and be able to implement additional measures.