Risk Factors for 30- and 1-year mortality in the Australian Hip Fracture Cohort: insights from the Australian and New Zealand Hip Fracture Registry

BACKGROUND: Geriatric hip fractures carry significant risk of mortality. Early identification and mitigation of mortality risk factors in this population is crucial to improve outcomes. We assessed these risk factors within the Australian hip fracture cohort. METHODS: A retrospective cohort study was performed using Australian and New Zealand Hip Fracture Registry (ANZHFR) data. The primary objective was to identify the pre-hospital risk factors for 30-day mortality. Secondary objectives were to assess the 1-year mortality and associated risk factors. Factors assessed included age, residence, surgical timing and reasons for delay. RESULTS: Mortality risk factors include increasing age, male sex, altered cognitive state at hospital presentation, increasing comorbidities, usual residence in a residential aged care facility and requirement for inter-facility transfer.Early surgical management was independently associated with a lower mortality risk. Delays of greater than 48 hours due to medical issues increased the odds of 30-day and 1-year mortality. Delays due to anticoagulation use or inter-facility transfer significantly increased the odds of 1-year mortality. CONCLUSIONS: Early surgical management is a modifiable risk factor that independently lowers mortality risk. This study supports the recent reduction in target time to surgery by the ANZHFR to improve patient outcomes.