Abstract

Introduction: Our objective was to analyze the mortality risk factors in older patients after hip surgery using comprehensive geriatric assessment (CGA).

Methods: In this prospective cohort study, old adults (≥ 60 years) who had undergone hip fracture surgery were enrolled in a single medical center fromJanuary 2020 to December 2021. The comprehensive geriatric assessment, as well as clinical information of each patient was recorded during the hospital stay. A Cox regression model was used to determine associations with survival.

Results: A total of 164 old patients (66 males and 98 females) with amean age of 81.09 ± 8.84 years were included. Twenty-seven patients died within one year (mortality rate 16.46%). In the Cox regression model, univariate analysis revealed male gender, older age, high American Society of Anesthesiologists grade (ASA = 4), length of hospital stay (≥ 10 days), activities of daily living (ADL) score at day of discharge, comorbidity with chronic obstructive pulmonary disease (COPD)/asthma or cancer, and postoperative infection (pneumonia or urinary tract infection) were associated with mortality. Female gender (hazard ratio [HR] = 0.40; 95% confidence interval [CI]: 0.17, 0.93; p = 0.033), higher discharge ADL score (HR = 0.97; 95% CI: 0.95, 1.00; p = 0.045), and postoperative infection (HR: 3.65; 95% CI: 1.25, 10.69; p = 0.018) remained significant predictors of one-yearmortality after adjustment for confounding factors.

Conclusions: Integrating clinical data with CGA effectively identifies older hip fracture patients at high mortality risk. Early identification of these patients and implementation of multidisciplinary comanaged care strategies are  recommended to potentially reduce one-year mortality.