Authors (including presenting author) :
Yim TK, Tso Luby, Sha KY
Affiliation :
Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
Long term outcome of Geriatric hip fracture patients is lacking. The total number of hip fracture patients admitted annually is increasing due to ageing population, despite reducing incidence rate of hip fracture with the improvement of fall prevention and bone health service. We are also expecting there will be increasing in frailty level of patients admitted for hip fracture.
Objectives :
Review the demographic and clinical data of Geriatric hip fracture patients in 2012-2015, and study their 5-year long term outcome including mortality, institutionalization and re-fracture rate. The findings are important as baseline for future audit exercise and guide our enhancement of fracture liaison service.
Methodology :
We created the United Christian Hospital Geriatric Hip Fracture database in 2012, by systemically recording the clinical data of geriatric hip fracture patients. From 2019, we reviewed their 5-year long term outcome, and compared the baseline demographic data and frailty level with geriatric hip fracture patients admitted in recent years.
Result & Outcome :
2225 hip fracture patients admitted from January 2012 to March 2015 were analyzed. 93% were aged 70 or older including 40.9% were aged older than 85. The 5-year mortality rate was 54%. There was statistical significant difference of 5-year mortality rate between male and female patients. For male patients it was 67% while for female patients was 47%. For patients survived after 5 years, 25.4% were staying in old aged home. 6.6% (147 patients) sustained second hip fracture over 5 years after the first hip fracture. Moreover, 8.9% of patients sustained another major osteoporotic fracture (excluding hip fracture) within 5 years. For imminent second fracture risk estimation (hip fracture or major osteoporotic fracture within 2 years post hip fracture), it was 1.3% for hip fracture and 1.9% for major osteoporotic fracture. 26.8% of patients in our database had been put on drug treatment for osteoporosis. When comparing the patients in 2012-2015 database and 2019-2020 database, we found there was a trend of increasing proportion of patients living with moderate to very severe frailty, as demonstrated by Clinical Frailty Scale 5 or above. Also more patients with terminal illnesses with clinical Frailty scale 9 was admitted with hip fracture in 2019-2020 (0.3% in 2012-2015 database and 2% in 2019-2020 database). We also noticed that the proportion of hip fracture patients aged older than 85 was increase from 41% to 52%.
