Epidemiology and outcome after hip fracture in the under 65s-Evidence from the Scottish Hip Fracture Audit

G. Holt, R. Smith, K. Duncan, J. D. Hutchison, A. Gregori

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Abstract

Aim: To report the epidemiology and outcomes after hip fractures in the patients under 65 years of age.

Patients and methods: We performed a prospective, multi-centre observational study using the Scottish Hip Fracture Audit Database. Case-mix, process and outcome data was collected by dedicated coordinators on site at the time of admission, at 120 days after the injury and on any re-operations within 12 months. The study cohort consisted of 1896 individuals aged 50-64 years. Patient variables and outcomes were compared to a control group of 15,461 individuals aged 75-89 years of age. The control group consisted of three modal 5-year age groups centred about a median age of 83 years, equal to the database value, excluding the effects of the extreme elderly who may act as confounders. Outcomes measures included 30- and 120-day mortality, length of hospital stay, place of residence and ambulatory status. A multivariate logistic regression model was used to compare outcome between groups white controlling for significant case-mix variables.

Results: Patients in the study cohort presented with Lower ASA scores and were more likely to be independently mobile and live in their own home at the time of fracture (p < 0.001). Pathological fractures were more common in younger patients and accounted for more than 1 in 20 fractures. Mortality at 30 and 120 days was significantly tower (p < 0.0001) in the study cohort, however it was increased compared to age and gender adjusted mortality rates for the general population (p < 0.001) Younger patients were more Likely to recover independent mobility and living.

Conclusion: Patients aged 50-64 years have significantly better outcome measures after surgery for hip fracture in terms of survival and function. Such differences exist even after controlling for differences in patient case-mix variables. (c) 2008 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1175-1181
Number of pages7
JournalInjury
Volume39
Issue number10
DOIs
Publication statusPublished - 2008

Keywords

  • age distribution
  • age factors
  • aged
  • aged, 80 and over
  • diagnosis-related groups
  • epidemiologic methods
  • female
  • hip fractures
  • humans
  • male
  • middle aged
  • prognosis
  • recovery of function
  • residence characteristics
  • Scotland
  • treatment outcome
  • young
  • hip fracture
  • audit
  • outcome
  • epidemiology
  • functional recovery
  • mortality
  • osteoperosis
  • predictors
  • survival
  • surgery
  • age

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