Predictors of Mortality and Institutionalization After Hip Fracture: the New Haven EPESE Cohort. Established Populations for Epidemiologic Studies of the Elderly

Overview

Journal Am J Public Health

Specialty Public Health

Date 1994 Nov 1

PMID 7977922

Citations 41

Authors

R A Marottoli

L F Berkman

L Leo-Summers

L M Cooney Jr

Affiliations

Soon will be listed here.

Abstract

Objectives: Hip fractures can have devastating effects on the lives of older individuals. We determined the frequency of occurrence of hip fracture and the baseline factors predicting death and institutionalization at 6 months after hip fracture.

Methods: A representative cohort of 2812 individuals aged 65 years and older was followed prospectively for 6 years. Hip fractures were identified, and the occurrence of death and institutionalization within 6 months of the fracture was determined. Prefracture information on physical and mental function, social support, and demographic features and in-hospital data on comorbid diagnoses, fracture site, and complications were analyzed to determine predictors of death and institutionalization after hip fracture.

Results: Of 120 individuals suffering a hip fracture, 22 (18%) died within 6 months and 35 (29%) were institutionalized at 6 months. The predictors of death in multiple logistic regression included fracture site, a high number of comorbid conditions, a high number of complications, and poor baseline mental status. The primary predictor of institutionalization was poor baseline mental status.

Conclusions: The frequency of death, institutionalization, and loss of function after hip fracture should prompt a reevaluation of the current approach to this problem.

Citing Articles

Mortality Rates and Forensic Causes after Hip Fracture: A Retrospective Observational Study.

Menekse S, Arslanoglu F, Zora H Arch Bone Jt Surg. 2025; 12(11):789-797.

PMID: 39850924 PMC: 11756537. DOI: 10.22038/ABJS.2024.77489.3580.

Subtype consideration in hip fracture research: patient variances in inter- and intra-classification levels highlight the need for future research deliberation. A 2-years follow-up prospective-historical cohort.

Balziano S, Greenstein N, Apterman S, Fogel I, Baran I, Prat D Arch Osteoporos. 2023; 18(1):123.

PMID: 37770694 DOI: 10.1007/s11657-023-01334-7.

Home discharge location is safest following fracture of the hip.

Deemer A, Ganta A, Leucht P, Konda S, Tejwani N, Egol K Eur J Orthop Surg Traumatol. 2023; 33(8):3539-3546.

PMID: 37219687 DOI: 10.1007/s00590-023-03551-9.

Associations between living alone, social interactions, and physical performance differ by sex: Results from the Baltimore Hip Studies.

Camara S, Falvey J, Orwig D, Gruber-Baldini A, Auais M, Feng Z J Am Geriatr Soc. 2023; 71(9):2788-2797.

PMID: 37171145 PMC: 10524112. DOI: 10.1111/jgs.18403.

Pre-operative Factors Predicting Mortality in Six Months and Functional Recovery in Elderly Patients with Hip Fractures.

Nam N, Minh N, Hai T, Sinh C, Loi C, Anh L Malays Orthop J. 2023; 17(1):10-17.

PMID: 37064636 PMC: 10103916. DOI: 10.5704/MOJ.2303.002.

References

Gerety M, Winograd C . Impact of prospective payment and discharge location on the outcome of hip fracture. J Gen Intern Med. 1989; 4(5):388-91. DOI: 10.1007/BF02599687. View

Mossey J, Mutran E, Knott K, Craik R . Determinants of recovery 12 months after hip fracture: the importance of psychosocial factors. Am J Public Health. 1989; 79(3):279-86. PMC: 1349547. DOI: 10.2105/ajph.79.3.279. View

Berkman L, Singer B, Manton K . Black/white differences in health status and mortality among the elderly. Demography. 1989; 26(4):661-78. View

Kellie S, Brody J . Sex-specific and race-specific hip fracture rates. Am J Public Health. 1990; 80(3):326-8. PMC: 1404674. DOI: 10.2105/ajph.80.3.326. View

Bonar S, Tinetti M, Speechley M, Cooney L . Factors associated with short- versus long-term skilled nursing facility placement among community-living hip fracture patients. J Am Geriatr Soc. 1990; 38(10):1139-44. DOI: 10.1111/j.1532-5415.1990.tb01378.x. View

Wood D, Ions G, Quinby J, Gale D, Stevens J . Factors which influence mortality after subcapital hip fracture. J Bone Joint Surg Br. 1992; 74(2):199-202. DOI: 10.1302/0301-620X.74B2.1544951. View

MULLEN J, Mullen N . Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. Clin Orthop Relat Res. 1992; (280):214-22. View

Marottoli R, Berkman L, Cooney Jr L . Decline in physical function following hip fracture. J Am Geriatr Soc. 1992; 40(9):861-6. DOI: 10.1111/j.1532-5415.1992.tb01980.x. View

OSTFELD A, Taylor J, Wallace R, Blazer D, Berkman L, Evans D . Established populations for epidemiologic studies of the elderly: study design and methodology. Aging (Milano). 1993; 5(1):27-37. DOI: 10.1007/BF03324123. View

10.

FITTS Jr W, LEHR H, Schor S, Roberts B . Life expectancy after fracture of the hip. Surg Gynecol Obstet. 1959; 108(1):7-12. View

11.

ROSOW I, Breslau N . A Guttman health scale for the aged. J Gerontol. 1966; 21(4):556-9. DOI: 10.1093/geronj/21.4.556. View

12.

Katz S, Downs T, CASH H, Grotz R . Progress in development of the index of ADL. Gerontologist. 1970; 10(1):20-30. DOI: 10.1093/geront/10.1_part_1.20. View

13.

Beals R . Survival following hip fracture. Long follow-up of 607 patients. J Chronic Dis. 1972; 25(4):235-44. DOI: 10.1016/0021-9681(72)90134-8. View

14.

Pfeiffer E . A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975; 23(10):433-41. DOI: 10.1111/j.1532-5415.1975.tb00927.x. View

15.

McCown P, Miller W . Long-term follow-up of hip fractures. South Med J. 1976; 69(12):1540-2. DOI: 10.1097/00007611-197612000-00007. View

16.

Miller C . Survival and ambulation following hip fracture. J Bone Joint Surg Am. 1978; 60(7):930-4. View

17.

Baker B, Duckworth T, Wilkes E . Mental state and other prognostic factors in femoral fractures of the elderly. J R Coll Gen Pract. 1978; 28(194):557-9. PMC: 2158818. View

18.

Jensen J, Tondevold E . Mortality after hip fractures. Acta Orthop Scand. 1979; 50(2):161-7. DOI: 10.3109/17453677908989751. View

19.

Dahl E . Mortality and life expectancy after hip fractures. Acta Orthop Scand. 1980; 51(1):163-70. DOI: 10.3109/17453678008990781. View

20.

Gallagher J, Melton L, Riggs B, Bergstrath E . Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res. 1980; (150):163-71. View