Characterization of Fragility Hip Fracture, Causes of Surgical Delay, and Mortality in a Tertiary Center in Palmira, Colombia
DOI:
https://doi.org/10.22517/25395203.25822Keywords:
Hip fracture, Geriatric syndromes, Mortality, Sarcopenia, Anemia, Chronic kidney disease, CharlsonAbstract
Introduction: Fragility hip fractures in older adults are associated with high morbidity, mortality, and disability, with a detrimental impact on quality of life in the older adult population.
Methods: A retrospective cohort study was conducted in a tertiary clinic in Colombia from January 2021 to December 2023. The objective of the study was to describe the clinical characteristics of older adult patients hospitalized with fragility hip fractures and to establish the factors associated with mortality and early versus late surgery.
Results: A total of 191 patients were analyzed. The median age was 84 years. The cumulative mortality rate at 12 months of follow-up was 13% (n=25/191). 48.7% of surgeries were performed in less than 48 hours. Factors associated with cumulative mortality at 12 months were a Charlson score greater than 5 and surgery performed more than 48 hours later. Factors associated with surgical delay were sarcopenia, CKD with a GFR < 45 ml/min, and hemoglobin levels on admission < 9 g/dL.
Conclusions: Elderly patients with hip fractures often have multimorbidity, which makes them more clinically complex. Medical evaluation should aim to identify and stabilize comorbidities to achieve early surgery. In Colombia, there may be gaps in achieving the goal of early surgery related to the type of health insurance. It is important to strengthen guidelines for the prevention of osteoporotic fractures and curb therapeutic inertia.
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