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Background <p>Hip fractures are a significant public health concern affecting millions of patients globally, particularly elderly and osteoporotic patients. The management of this injury is typically surgical in order to facilitate early mobilization; however, a small subset of patients is managed non-operatively.</p> Aims <p>The aims of this study were to evaluate patients with hip fractures managed non-operatively in Ireland to determine their clinical outcomes and mortality rates post-injury.</p> Methods <p>A retrospective cohort study using data from the Irish Hip Fracture Database (IHFD) from 2017 to 2021 was carried out. The primary outcome was 30-day mortality, with secondary variables including admission source, gender, age, pre-injury outdoor mobility, pressure ulcer development, hospital length of stay, and discharge destination.</p> Results <p>Among 15,427 patients, 3% received non-operative care (<i>n</i> = 405). Mortality at 30&#xa0;days was significantly higher in hip fracture patients managed non-operatively (21% versus 4%; <i>p</i> &lt; 0.001). Displaced intracapsular and subtrochanteric fractures were associated with higher mortality, while periprosthetic fractures were associated with survival (relative risk 2.57 and 2.55, respectively, <i>p</i> &lt; 0.001 versus RR 0.09 <i>p</i> &lt; 0.001). Independent pre-fracture mobility was also associated with survival in non-operatively managed patients (RR 0.32 <i>p</i> &lt; 0.001).</p> Conclusions <p>Non-operative management of hip fractures is associated with significantly higher mortality rates compared to surgical intervention at 30&#xa0;days post-injury. Fracture morphology in the form of unstable patterns including displaced intracapsular and sub-trochanteric fractures are negative prognostic factors for such patients managed non-operatively, whilst independent pre-fracture mobility was correlated positively with post-injury clinical outcomes.</p>

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Comparing clinical outcomes and mortality rates of patients who sustained hip fractures managed non-operatively versus operatively over a 5-year period across the Republic of Ireland

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Nicolas Christodoulou,
  • Martin S. Davey,
  • Fred Kenny,
  • Adrian J. Cassar-Gheiti,
  • Patrick Kenny

摘要

Background

Hip fractures are a significant public health concern affecting millions of patients globally, particularly elderly and osteoporotic patients. The management of this injury is typically surgical in order to facilitate early mobilization; however, a small subset of patients is managed non-operatively.

Aims

The aims of this study were to evaluate patients with hip fractures managed non-operatively in Ireland to determine their clinical outcomes and mortality rates post-injury.

Methods

A retrospective cohort study using data from the Irish Hip Fracture Database (IHFD) from 2017 to 2021 was carried out. The primary outcome was 30-day mortality, with secondary variables including admission source, gender, age, pre-injury outdoor mobility, pressure ulcer development, hospital length of stay, and discharge destination.

Results

Among 15,427 patients, 3% received non-operative care (n = 405). Mortality at 30 days was significantly higher in hip fracture patients managed non-operatively (21% versus 4%; p < 0.001). Displaced intracapsular and subtrochanteric fractures were associated with higher mortality, while periprosthetic fractures were associated with survival (relative risk 2.57 and 2.55, respectively, p < 0.001 versus RR 0.09 p < 0.001). Independent pre-fracture mobility was also associated with survival in non-operatively managed patients (RR 0.32 p < 0.001).

Conclusions

Non-operative management of hip fractures is associated with significantly higher mortality rates compared to surgical intervention at 30 days post-injury. Fracture morphology in the form of unstable patterns including displaced intracapsular and sub-trochanteric fractures are negative prognostic factors for such patients managed non-operatively, whilst independent pre-fracture mobility was correlated positively with post-injury clinical outcomes.