In-hospital mortality risk of intertrochanteric hip fractures: a comprehensive review of the US Medicare database from 2005 to 2010

• Published in: Musculoskeletal surgery Vol. 101; no. 3; pp. 213 - 218
• Main Authors: Kiriakopoulos, E., McCormick, F., Nwachukwu, B. U., Erickson, B. J., Caravella, J.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.12.2017; Springer; Springer Nature B.V
• Subjects: Age Factors; Aged; Aged, 80 and over; Female; Fractures; Fractures, Closed - mortality; Hip Fractures - mortality; Hip joint; Hospital Mortality; Humans; Male; Medicare; Medicare - statistics & numerical data; Medicine; Medicine & Public Health; Mortality; Original Article; Orthopedics; Risk; Sex Factors; Surgical Orthopedics; United States - epidemiology; Hip fracture; Intertrochanteric; Mortality rate; Trauma
• DOI: 10.1007/s12306-017-0470-3
• ISSN: 2035-5106

Purpose Intertrochanteric hip fracture is a common injury in the Medicare population. Very little is known about the in-hospital mortality risk of intertrochanteric hip fractures and associated demographics for the US Medicare population. The purpose of this study is to determine the in-hospital mortality rate of closed intertrochanteric hip fractures and to evaluate demographic factors influencing an increased mortality risk. Methods The PearlDiver Medicare database from 2005 to 2010 was queried for closed intertrochanteric hip fractures. Stratified sampling was conducted by creating subset for individuals with a death discharge from inpatient facilities. Statistical analysis was performed where appropriate. Results Throughout 2005–2010 there were a total of 1,138,142 intertrochanteric hip fractures. There were 19,385 deaths during the initial hospital stay, yielding a mortality rate of 1.70%. There was a 1.83% mortality rate for patients 75 and older and patients over the age of 84 comprised the majority of deaths at 58%. The mortality rate was lower for females (1.39%) than for males (2.56%) ( p  < 0.0002). Conclusion We found in the Medicare database that there is a relatively low rate of in-hospitality mortality associated with intertrochanteric hip fractures; this rate is lower than previously reported. We report a 1.70% in-hospital mortality using a complete Medicare dataset. Based on previous reporting for short term and one-year mortality risk, the present study suggests that mortality risk is greatest after patients have been released from the hospital. More attention should be paid to understanding and attenuating the mortality associated with intertrochanteric hip fractures after the acute hospital phase.