Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan.

Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan.

Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models.

Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, = 45). Log-rank test revealed that previous fractures ( = 0.003), Barthel index (BI) at discharge ( = 0.011), and place-to-discharge ( = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; = 0.023), total Charlson comorbidity index (TCCI; = 0.005), smoking ( = 0.007), length of hospital stay (LOS; = 0.009), and BI ( = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; = 0.044), and BI <30 (HR 5.42, = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m (HR 2.70, = 0.023), TCCI ≥5 (HR 2.61, = 0.032), smoking history (HR 3.59, = 0.018), LOS <14 days (HR 13.9; = 0.007), and BI <30 (HR 2.76; = 0.049) were the counterparts for females.

Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m, TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.