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Hip Fracture - Morbidity And Mortality

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The one-year mortality after hip fracture ranges from 12 to 36 percent. The highest risk of mortality appears to be in the first four to six months, and there is also significant intrahospital mortality. These rates are significantly higher than age-matched controls. Following one-year postfracture, the mortality rate appears to drop back to age-matched control rates. Factors associated with increased mortality include advanced-stage impaired cognition, institutionalization, cardiovascular disease, and male gender.

Morbidity rates are also quite significant. In the early hospital course, patients are at risk for fracture disease. This includes pneumonia, urinary tract infections, decubitus ulcers, and thromboembolic disease. Additionally, cognitive impairment can be exacerbated. This is often multifactorial in nature, with analgesic medication and other polypharmacy effects, complications of the fracture disease, and even the sudden change in environment all implicated.

PETER ROCKWOOD, M.D.

BIBLIOGRAPHY

BEATY, J. H. Orthopedic Knowledge Update 3-Home Study Syllabus. American Academy of Orthopaedic Surgeons, 1999.

CRENSHAW, A. H. Campbell's Operative Orthopedics, vol. 2, 8th ed. St. Louis, Mo.: Mosby Year Book, 1992.

ROCKWOOD, CHARLES A., and GREEN, DAVID P. Rockwood and Greene's Fractures in Adults, 5th ed. Philadelphia: Lippincott-Williams & Wilkins, 2001.

ROCKWOOD, PETER R.; ROCKWOOD, KENNETH J.; and EATON, WILLIAM H. "Elderly Long-Stay Surgical Patients." Canadian Journal of Surgery 31, no. 1 (1988): 62–64.

ROCKWOOD, PETER R., and HORNE, J. GEOFFREY. "Hip Fractures: A Future Epidemic?" Journal of Orthopedic Traumatology 4 (1990): 388–393.

WIESEL, SAM. W., and DELAHAY, JOHN N. Essentials of Orthopedic Surgery, 2d ed. Philadelphia: W.B. Saunders Company, 1997.

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