Trends, patterns, and outcomes of hip fractures over 14 years: insights from a tertiary trauma center in Beijing, China (2009-2022).

UNLABELLED: Over 14 years, hip fracture patients grew older, with shorter hospital stays. Femoral neck fractures were more common than intertrochanteric fractures, but the latter had worse functional outcomes and higher complications. Surgery was standard, with nailing for intertrochanteric and arthroplasty for femoral neck fractures. Older age increased adverse outcomes.

AIM: We aimed to investigate trends in patient characteristics and outcomes in patients after hip fractures.

METHODS

We analyzed data from hip fracture patients treated at our trauma center between January 2009 and December 2022. Variables included fracture type, sex, age, BMI, admission/discharge times, anesthesia type, ASA classification, treatment methods, surgery duration, discharge activities of daily living, and complications.

RESULTS

This retrospective study of 2965 hip fracture patients revealed a predominance of femoral neck fractures (56.6%) over intertrochanteric fractures (43.4%), with females comprising two-thirds of cases. Mean patient age increased significantly over time, particularly for intertrochanteric fractures (79.4 vs. 75.0 years for femoral neck). Hospital stays markedly decreased (25.5 to 9.1 days for intertrochanteric; 20.2 to 8.9 days for femoral neck). Intertrochanteric fractures were associated with worse functional outcomes (discharge ADL, 38.5 vs. 42.2, P = 0.009) and higher ICU admission (11.4% vs. 6.0%, P < 0.001). Surgical management dominated (92.3%), with intramedullary nailing for intertrochanteric fractures (86.3%) and arthroplasty for femoral neck fractures (73.7%). ASA classification indicated poorer physiological status in intertrochanteric fracture patients (P < 0.001). In-hospital mortality escalated with age and prolonged injury-to-admission time (P < 0.001).

CONCLUSION

During 2009-2022, the mean age of hip fracture patients increased significantly, while hospital stays decreased. Intertrochanteric fractures were associated with poorer functional outcomes and higher complication rates compared to femoral neck fractures. Surgical management, particularly intramedullary nailing and arthroplasty, predominated. Older adults exhibited the higher burden of adverse outcomes, with mortality and complications rising with age.