Changes in hip fracture incidence, mortality and length of stay over the last decade in an Australian major trauma centre.

PURPOSE: The aim of this study was to describe the population-based longitudinal trends in incidence, 30-day mortality and length of stay of hip fracture patients in a tertiary referral trauma centre in Newcastle, New South Wales, Australia, and identify the factors associated with increased 30-day mortality.

METHODS: A retrospective database and chart review was conducted to patients aged ≥65 years with a diagnosis of femoral neck or pertrochanteric fracture admitted to the John Hunter Hospital between 01 January 2002 and 30 December 2011. The main outcome measure was 30-day mortality; secondary outcome was acute length of stay.

RESULTS: There were 4,269 eligible patients (427±20 per year) with hip fractures over the 10-year study period. The absolute incidence increased slightly (p=0.1) but the age-adjusted rate decreased (p≤0.0001). The average age (83.5±7.1 years) and percentage of females (73.7%) did not change. Length of stay increased by a factor of 2.5% per year (p<0.0001). Thirty-day mortality decreased from 12.3% in 2002 to 8.20% in 2011 (p=0.0008). Independent risk factors associated with increased 30-day mortality were longer admissions (p<0.0001), increased age (p=0.005), dementia (p=0.01), male gender (p<0.0001), higher American Society of Anaesthesiologists score (p<0.0001), and longer time to operating theatre (p=0.002).

CONCLUSIONS: Despite the relative ageing of our population, a decrease in the age-standardised rate of fractured hip in elderly patients has seen the number of admissions remain unchanged in our institution from 2002 to 2011. There was a decrease in 30-day mortality, while length of stay increased.