Hip fracture sustained as inpatient vs outpatient event led to higher mortality risk
Patients who sustained a hip fracture in hospital had a higher mortality risk than patients who sustained a hip fracture outside the hospital, according to results presented at the Virtual EFORT Congress.
Using data from a local prospectively collected hip fracture registry, Haseeb Khawar, MBBS, MSc, and colleagues categorized patients into groups based on whether they sustained a hip fracture as a hospital inpatient or within the community. In his presentation, which received the Silver Award for Trauma, Khawar noted the team performed propensity score matching on the inpatient and outpatient groups, and compared 30-day and 1-year mortality between the groups.
“As a secondary analysis, we performed binomial regression on the baseline cohort in order to establish the significant predictors of 1-year mortality,” Khawar said.
At baseline, prior to propensity score matching, results showed significantly higher rates of chronic kidney disease, diabetes, cerebrovascular accident, chronic obstructive pulmonary disease and active cancer in the inpatient group.
“After propensity score matching, both groups are now equal with regard to their comorbidity status,” Khawar said. “Despite us matching for comorbidity, mortality at both 30 days and 1 year was still significantly higher in our inpatient group then compared to the outpatients.”
Regression analysis on the baseline cohort showed a significant increase in 1-year mortality risk among patients who sustained a hip fracture as an inpatient, according to Khawar.
“We need to conduct more work and more study in order to determine the reason for the inpatients dying more than the outpatients,” Khawar said. “In our study, we have tried to show that the reason is not because the inpatient group are more comorbid or sicker than the outpatient group. There are other unknown factors at play which [are] influencing mortality in both groups.”