CLINICAL OUTCOMES AND MORTALITY AFTER HIP FRACTURE - A 2-YEAR FOLLOW-UP-STUDY

The aim of this study was to evaluate the burden of hip fractures, whi ch occurred in the French region of Picardie, in 1992, among 1103 wome n and 356 men, whether the fractures occurred at home or in a communit y (i.e., patients who depended on a collective service). The data are part of the PICAROS study, which was designed to assess prospectively the outcome of patients as judged by clinical, economical, and quality of life factors. Patients and/or proxies were questioned during the 2 nd or 3rd week following the fracture, and again at 3, 6, 12, and 24 m onths after the fracture. The survey was conducted by home interview. Recruitment criteria were: 1) all patients with a hip fracture as defi ned by the International Classification of Disease (ICD); 2) 20 years of age and over; 3) admitted to one of the 34 surgical units from the region, public and private, and had an operation or not. Patients with metastatic or myelomatous fractures or fractures on prothesis device were not included. For the present analysis, patients under 50 years o f age were excluded. Among people aged 50 years and over, 3% of the ge neral population lived in a community; 32% of hip fractures were from a community. Patients in a community, aged 60-69, had 15 times more ri sk of having a hip fracture than subjects of the same age at home. The excess risk decreased with age and stabilized over 85 years of age at two to threefold. During the 24 month follow-up, 394 women and 173 me n died. Among those surviving, 87% were interviewed at 2 years. We ana lysed seven classes of complications, according to the ICD: (1) pressu re sores and blisters; (2) pulmonary infections; (3) urinary infection s; (4) surgical complications; (5) orthopedic complications; (6) throm bosis and embolisms; and (7) secondary hip fractures. Patients coming from a community had a higher risk of mortality, pressure sores, surgi cal complications, and pulmonary and urinary infections. From an econo mical perspective, the institutionalized population would seem to be a profitable target for the prevention of fractures and their complicat ions.