One Year On: Mortality After Hip Fracture in Older Adults

Abstract Background Hip fractures are among the most serious and debilitating type of fragility fracture, contributing significantly to both morbidity and mortality in older adults. International data shows elevated mortality rates following hip fracture, with all-cause mortality rates 2.9% at one month, and 16.6% at one year. This study investigates the 12-month mortality rates for hip fracture patients at a Model 3 Hospital in Ireland. Methods The study was approved by the local Audit and Quality Improvement Department. Data from the 2023 Irish Hip Fracture Database (IHFD) for our was examined. Mortality data was also extracted from the hospitals’ electronic patients information system. Results 275 hip fractures were recorded in 2023. The overall mortality rate for hip fracture patients at one year was 16% . 19% of these deaths occurred during the index hospital stay. 30% of the deaths occurred within one month of presentation with a hip fracture. The study cohort age range was 63 – 103 years. The age of deceased patients ranged from 63 to 103 years; 56% were male. 46% were admitted from home, 39% from long-term care, and 13% were transferred from other hospitals. 91% were classified as low velocity fractures. 20% of the study cohort were independently mobile prior to their hip fracture, 30% independent with an aid, 30% required assistance of one, and 9% were classed as dependent. 74% of deceased patients had an ASA grade of 3, and 16% had a grade of 4. Conclusion One year hip fracture mortality was consistent with international data at 16%. Our study demonstrated a high level of premorbid mobility in our hip fracture deaths and this combined with the majority of the deaths having an ASA grade of 3 suggests further study is needed into predictors of mortality in this population.