Changes in hip fracture incidence, mortality and length of stay over the last decade in an Australian major trauma centre

Purpose The aim of this study was to describe the population-based longitudinal trends in incidence, 30-day mortality and length of stay of hip fracture patients in a tertiary referral trauma centre in Newcastle, New South Wales, Australia, and identify the factors associated with increased 30-day mortality. Methods A retrospective database and chart review was conducted to patients aged >= 65 years with a diagnosis of femoral neck or pertrochanteric fracture admitted to the John Hunter Hospital between 01 January 2002 and 30 December 2011. The main outcome measure was 30-day mortality; secondary outcome was acute length of stay. Results There were 4,269 eligible patients (427 +/- 20 per year) with hip fractures over the 10-year study period. The absolute incidence increased slightly (p=0.1) but the age-adjusted rate decreased (p <= 0.0001). The average age (83.5 +/- 7.1 years) and percentage of females (73.7 %) did not change. Length of stay increased by a factor of 2.5 % per year (p < 0.0001). Thirty-day mortality decreased from 12.3 % in 2002 to 8.20 % in 2011 (p=0.0008). Independent risk factors associated with increased 30-day mortality were longer admissions (p < 0.0001), increased age (p=0.005), dementia (p=0.01), male gender (p<0.0001), higher American Society of Anaesthesiologists score (p < 0.0001), and longer time to operating theatre (p=0.002). Conclusions Despite the relative ageing of our population, a decrease in the age-standardised rate of fractured hip in elderly patients has seen the number of admissions remain unchanged in our institution from 2002 to 2011. There was a decrease in 30-day mortality, while length of stay increased.