Systematic Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2019; 10(3): 166-175
Published online Mar 18, 2019. doi: 10.5312/wjo.v10.i3.166
Changing trends in the mortality rate at 1-year post hip fracture - a systematic review
Colum Downey, Martin Kelly, John F Quinlan
Colum Downey, Martin Kelly, John F Quinlan, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin 01, Ireland
Author contributions: Downey C, Kelly M and Quinlan JF contributed equally to this work. Downey C and Quinlan JF designed research. Downey C, Kelly M performed research. Downey C wrote the paper.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Colum Downey, BSc, MBBS, MSc, Doctor, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin 01, Ireland. columdowney@rcsi.ie
Telephone: +353-1-4144090 Fax: +353-1-4144779
Received: October 10, 2018
Peer-review started: October 10, 2018
First decision: October 25, 2018
Revised: January 1, 2019
Accepted: February 27, 2019
Article in press: February 27, 2019
Published online: March 18, 2019
ARTICLE HIGHLIGHTS
Research background

Hip fracture audit is increasing globally with 8 countries producing national reports annually and several countries currently piloting hip fracture audit schemes. Hip fracture audit has been shown to result in improvements in care and survival of older people. Short-term mortality rates (in-patient and 30-d) are published by the majority of national registries and there is evidence that short term mortality rates are decreasing. The 1-year mortality rate post hip fracture is currently recognized as approximately 30%. Recent longer-term (1-year) mortality information is lacking in the literature.

Research motivation

Our research group believes there may also be a changing trend (decreasing) in 1-year mortality post hip fracture. Knowledge of a more current, up-to-date figure will lead to a more informed discussion with family of those affected and optimization of care of this fragile cohort at hospital and national levels.

Research objectives

To determine the current 1-year mortality rate post hip fracture.

Research methods

Systematic literature review. The following keywords were used: “hip fracture”, “mortality”, “year”, “death”, “outcomes”, “registry”, “registries”, “database” and “databases” (PubMed and Google Scholar). The inclusion criteria were those studies published within the last 5 years (2013-2017), studies including a cohort >100 and those in the English language.

Research results

Data from 8 national registries and 36 countries (6 continents) were reviewed. Recently published 1-year mortality rates appear lower than traditional figures and suggest a downward trend.

Research conclusions

The previously quoted 1-year mortality rate of approximately 30% appears to be outdated. A figure of 22% is a more accurate, up-to-date figure for 1-year mortality rate post hip fracture.

Research perspectives

This research provides a more current, up-to-date figure for 1-year mortality rate post hip fracture.