PREDICTING IN-HOSPITAL MORTALITY AFTER HIP FRACTURE IN ELDERLY PATIENTS

Ninety-seven patients aged 88 +/- 4 years (range, 80-97 years) (study group), and 74 aged 75 +/- 3 years (range, 70-79 years) (control group ), were prospectively studied to investigate whether basic medical var iables can predict in-hospital mortality in very old patients undergoi ng hip surgery because of femoral fracture. Mortality was 16.5% and 6. 7% in the study and control groups, respectively (p = 0.054). In the s tudy group, mortality was significantly correlated with age (p < 0.01) , venous disorders (p < 0.05), malnutrition (p < 0.0001), duration of surgery (p < 0.006), and postoperative noninfectious complications (p < 0.005). In the control group, age was the only significant correlate of mortality (p < 0.005). After exclusion of surgery-related variable s, the logistic regression analysis confirmed the predictive role of v enous disorders (odds ratio = 2.04, confidence limits = 1.09-3.79) and malnutrition (odds ratio = 6.01, confidence limits = 1.85-19.47) but not of age in the study group. However, the goodness-of-fit test showe d that the statistical model did not fit the data adequately. We concl ude that in-hospital mortality after hip surgery in the very old canno t be predicted on the basis of underlying medical conditions alone.