To describe trends in 30-day mortality after hip fracture surgery from 2011-2017, identify predictors of mortality, and develop risk calculators.
Key Findings:
Overall 30-day mortality after hip fracture surgery was 6.8%, decreasing from 8.1% in 2011 to 6.5% in 2017 (P < .001).
Significant preoperative predictors included male gender, age, lower BMI, poorer functional health status, and comorbidities such as congestive heart failure and chronic obstructive pulmonary disease.
On-discharge predictors included most preoperative factors plus unplanned intubation, cerebrovascular accident, myocardial infarction, and pneumonia.
The preoperative risk calculator had an AUC of 0.739, while the on-discharge calculator had an AUC of 0.800.
Interpretation:
Mortality rates after hip fracture surgery have significantly decreased over time, with identifiable clinical risk factors that can inform surgical decision-making and improve patient outcomes.
Limitations:
Data only covers 2011-2017, limiting long-term trend analysis.
Potential biases in the NSQIP database due to its observational nature may affect the reliability of the findings.
Conclusion:
The study highlights a significant decrease in 30-day mortality rates and provides useful risk calculators to guide clinical practice.
