Risk factors for 30-days mortality after proximal femoral fracture surgery, an extensive cohort study

Purpose: The primary objective of this study was to identify new risk factors and to confirm previously reported risk factors associated with 30-day mortality after hip fracture surgery.

Patients and methods: A prospective hip fracture database was used to obtain data. In total, 3523 patients who underwent hip fracture surgery between 2011 and 2021 were included. Univariable and multivariable logistic regression was used to screen and identify candidate risk factors.

Results: 8.6% of the patients who underwent hip fracture surgery died within 30 days after surgery. The multivariable analysis identified prognostic factors associated with 30-day mortality after hip fracture surgery. Including: age 90-100 years (OR=4.7, p=0.041) and above 100 years (OR=11.3, p=0.029), male gender (OR=2.6, p<0.001), American Society of Anesthesiologists (ASA) 3 and ASA 4 (OR=2.1, p<0.001), medical history of dementia (OR=1.7, p=0.001), decreased albumin level (OR=0.94, p<0.001), decreased glomerular filtration rate (GFR) (OR=0.98, p<0.001), residential status of nursing home (OR=2.1 p<0.001), higher Katz Index of Independence in Activities of Daily Living (KATZ-ADL) score (OR=1.1, p=0.018) and postoperative pneumonia (OR=2.4 p<0.001).

Conclusion: Significant independent prognostic risk factors for 30-day mortality after multivariable analysis were age above 90 years, male gender, ASA 3 and ASA 4, medical history of dementia, decreased albumin, decreased GFR, residential status of nursing home, higher KATZ-ADL score and postoperative pneumonia.

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