Hip Fracture May Have Grave Consequences

Hip fracture patients in nursing homes faced increased risk of death in recent study

/ Author:  / Reviewed by: Dominique Brooks, M.D Beth Bolt, RPh

(RxWiki News) Nursing homes provide around-the-clock care, primarily for older people with existing health problems. While many conditions can be managed over the long-term, some injuries like hip fracture can have severe short-term consequences.

A recent study found that nursing home patients who fractured their hips faced a significantly higher risk of death following the injury.

Even more at-risk were nursing home residents with brain function problems and residents 90 and older.

"Discuss how to avoid hip fractures with nursing home caregivers."

The study was conducted by Mark Neuman, MD, MSc, of the Department of Anesthesiology and Critical Care at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia, and colleagues.

The researchers set out to study patterns associated with functional decline following hip fracture in nursing home patients.

The study included 60,111 patients who fractured their hips. Of those, 21,766 (36.2 percent) died within 180 days of the injury.

Of the study participants who had some mobility prior to the hip fracture, 53.5 percent either died or became totally dependent on caregivers within the 180-day time frame.

The patients most at risk of death following hip fracture were 90 or older. That group was 2.17 times more likely to die than study participants between 75 and 90.

Nursing home residents with brain function impairments were 1.66 times more likely than those with normal brain function to die following hip fracture.

The authors of this study also found that residents who did not receive surgery for a hip fracture were 2.08 times more likely to die than patients who received surgery.

The authors suggested that these trends should be considered in patient care planning at nursing homes.

In a corresponding editorial, Fred Ko, MD, MS, and Sean Morrison, MD, wrote that hip fracture can have "devastating consequences," and Dr. Nueman's study has "tremendous implications on the clinical care of vulnerable older adults with hip fractures."

They recommended what's called "palliative care," in which numerous specialists work to improve patient quality of life with pain management, care goals and other types of support.

The study was published online June 23 by the peer-reviewed journal JAMA Internal Medicine.

The National Institute on Aging provided funding. A study co-author disclosed paid consulting work with a number of private companies.

Review Date: 
August 4, 2014
Last Updated:
August 4, 2014