Hip fractures carry an approximately 30% risk of mortality at 1 year.[28]North American Menopause Society. Management of osteoporosis in postmenopausal women: the 2021 position statement of the North American Menopause Society. Menopause. 2021 Sep 1;28(9):973-97.
https://www.doi.org/10.1097/GME.0000000000001831
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[107]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
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[108]Fredman L, Hawkes WG, Black S, et al. Elderly patients with hip fracture with positive affect have better functional recovery over 2 years. J Am Geriatr Soc. 2006 Jul;54(7):1074-81.
http://www.ncbi.nlm.nih.gov/pubmed/16866678?tool=bestpractice.com
About 25% to 75% of community-dwelling adults may not regain their pre-fracture level of function.[109]Thorngren KG. Fractures in the elderly. Acta Orthop Scand Suppl. 1995 Oct;266:208-10.
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[110]Thorngren KG. Fractures in older persons. Disabil Rehabil. 1994 Jul-Sep;16(3):119-26.
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[111]Borgquist L, Ceder L, Thorngren KG. Function and social status 10 years after hip fracture. Prospective follow-up of 103 patients. Acta Orthop Scand. 1990 Oct;61(5):404-10.
http://www.ncbi.nlm.nih.gov/pubmed/2239162?tool=bestpractice.com
[112]Marottoli RA, Berkman LF, Cooney LM Jr. Decline in physical function following hip fracture. J Am Geriatr Soc. 1992 Sep;40(9):861-6.
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Predictors of mortality include significant comorbid disease, low pre-injury cognitive function, abnormal preoperative ECG, age >85 years, and decreased pre-fracture mobility.[94]Smith T, Pelpola K, Ball M, et al. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. Age Ageing. 2014 Jul;43(4):464-71.
https://academic.oup.com/ageing/article/43/4/464/2812257/Pre-operative-indicators-for-mortality-following
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[113]Marottoli RA, Berkman LF, Leo-Summers L, et al. Predictors of mortality and institutionalization after hip fracture: the New Haven EPESE (Established Populations for Epidemiologic Studies of the Elderly) cohort. Am J Public Health. 1994 Nov;84(11):1807-12.
http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.84.11.1807
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Guidelines recommend surgery on the day of, or the day after, admission to avoid increased risk of mortality.[45]National Institute for Health and Care Excellence. Hip fracture: management. January 2023 [internet publication].
https://www.nice.org.uk/guidance/cg124
[46]Scottish Hip Fracture Audit & Advisory Group. Scottish standards of care for hip fracture patients. 2020 [internet publication].
https://www.shfa.scot.nhs.uk/_docs/2020/Scottish-standards-of-care-for-hip-fracture-patients-2020.pdf
[47]Royal College of Physicians. Improving understanding: the National Hip Fracture Database report on 2021. 2022 [internet publication].
https://www.nhfd.co.uk/FFFAP/Reports.nsf/0/EA5D572779948D14802588D8005C1A99/$file/NHFD%202022%20Annual%20Report%20v1a.pdf
Early surgery:
Allows earlier mobilisation and functional recovery
Is associated with less pain and reduced length of hospital stay.[95]Orosz GM, Magaziner J, Hannan EL, et al. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004 Apr 14;291(14):1738-43.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1454713
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Patients with a positive affect who are in good health and live with someone had a better prognosis for good outcome.[107]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
http://www.ncbi.nlm.nih.gov/pubmed/2335719?tool=bestpractice.com
[111]Borgquist L, Ceder L, Thorngren KG. Function and social status 10 years after hip fracture. Prospective follow-up of 103 patients. Acta Orthop Scand. 1990 Oct;61(5):404-10.
http://www.ncbi.nlm.nih.gov/pubmed/2239162?tool=bestpractice.com
Older age and increasing length of hospital stay result in a poorer prognosis and outcome in regard to return to pre-fracture functional status.[107]Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101-7.
http://www.ncbi.nlm.nih.gov/pubmed/2335719?tool=bestpractice.com