Clinical Outcomes in Elderly Patients with a Hip Fracture (CHIEF Sub-Study).

Hip fractures (HF) in the elderly are a leading cause of morbidity and mortality in orthopaedic surgery and impose heavy medico-economic burden on the health system. A recent editorial1 has called for large observational studies in various countries so that comparative effectiveness research is possible for this population. In Australia, there are only a few small studies reporting on mortality rates with minimal exploration into other outcome measures and therefore a research gap on local data is present. Aim(s): This study aims to estimate the mortality rates in the elderly patients presenting with HF, the survival days until study cut-off date and days alive out of hospital at 90 days (DAOH-90d) after hospital admission (non-operative group) or surgical repair (operative group). Method(s): A historical cohort study was performed on patients aged 70 years or older, who were admitted to a Victorian metropolitan hospital during the period July-2011 to July-2015 due to HF. After institutional ethics approval, the hospital's diagnostic-related-group database identified 1048 eligible patients. Of this, 105 patients were excluded from this study due to incomplete data, predominately because of hospital transfers. Based on the mortality data, retrieved from Victorian Registry of Births, Death and Marriages, the survival days up to the study cut-off date (1st August 2016, i.e., one year after the last patient's operation) and DAOH-90d were calculated. Unpaired t test and descriptive statistics were used. Result(s): Demographics data was extracted from electronic patient records (Table 1). The mortality rates for non-operative patients were 26% at 30 days, 31% at 90 days and 45% at one year; for operative patients, 10%, 17% and 28% respectively. When comparing between non-operative and operative groups (Figure 1), there was a significant difference in survival days (pA0.019) with the average of 595 (95% confidence interval (CI) 490 to 701) versus 720 days (95% CI 684 to 75