Endocrine Abstracts

Background: Excess mortality after hip fracture remains a problem of public health concern. Until present, for Romania no data is available regarding long term mortality rate and excess mortality after hip fracture. We aimed to evaluate the mortality rate 3 years after hip fracture and also standardized mortality rates of osteoporotic hip fracture in the capital city of Romania and suburban area.

Methods: we collected data from over 98 % of fractures admitted during 12 months (09/01/2017 - 08/31/2018) in Orthopedic Surgery Departments in the area of interest. Patients were selected using the hip fracture codes (S72.0, 1, 2, 3, 7, 8, 9), age >40 years old and low-trauma mechanism (fall from a standing height or less). We used the 2018 estimations for stable population in the area selected. We calculated the mortality rate (MR) 3 years after the event and standardized mortality rates (SMR) of hip fracture.

Results: we included a total of 1977 patients with fragility hip fracture (86.5% in the capital city and 13.5 % in the suburban area). MR after 3 years was 46.42% in all patients with a mean age of 81 years old, 69% women. Almost a quarter of patients were not surgically treated. Advanced age, male sex, extracapsular fracture and especially conservative management were associated with increased mortality. SMR after 1^st 2^nd and 3^rd year and cumulative for the whole 3-year period in all patients were 13.69, 5.45, 5.94 and 26.06 respectively. As expected, SMR decreased with advancing age, but remained higher even in patients >85 years old (2.79 for 1^st year, 2.34 for 3-year period). Notable differences were observed in SMR between sexes, 29.18 for women and 19.6 for men, 3 years after the fracture.

Conclusion: this is the first study to describe the long-term mortality rate and excess mortality after osteoporotic hip fracture in Romania. Hip fracture has the highest impact on short-time mortality, the risk in the 2^nd and 3^rd year being significantly smaller compared to 1^st year. Even after 3 years, excess mortality for hip fracture patients can be still observed.