Determinants of patient satisfaction and expectation after hip fracture surgery: a multidimensional perspective on association between clinical outcomes, subjective expectations and psychosocial factors.

BACKGROUND AND OBJECTIVES: Hip fracture represents a singular traumatic experience with substantial health and socioeconomic repercussions in the elderly. While clinical and functional outcomes are well established, patient experience has emerged as another measure of quality-of-care. However, factors influencing patient experience after osteoporotic hip fracture surgery remain poorly defined. This study aims to determine factors influencing postoperative satisfaction and patient expectation. MATERIALS AND METHODS: Retrospective analysis of a prospectively followed up cohort (n = 257) of hip fracture patients (1st of January–31st of December 2023) was performed. Demographics, co-morbidities and patient-reported outcome measures (EQ5D, NPRS, HHS and SF36) were correlated with 6-month postoperative satisfaction (6-point Likert scale) and expectation (7-point Likert scale). Statistical analyses included normality testing, univariate analysis and ordinal logistic regression (SPSS v29.0.2.0, α = 0.05), with Spearman’s correlation and odds ratios reported for significant variables in logistic regression. RESULTS: Among 257 patients (74 males, 183 females; mean age 79.0 ± 8.0 years), 59% sustained NOF and 41% IT fractures. Overall satisfaction was 95%, and expectations were met in 90% of patients, with females reporting higher satisfaction (96%) and expectation fulfilment (91%). Multivariate analysis identified gender (OR = 0.49, p = 0.013), 6-month EQ-Health (OR = 1.03, p = 0.002), and MH scores (OR = 1.02, p = 0.044) as predictors of satisfaction, while expectation fulfilment was significantly associated with EQ-Health (OR = 1.03, p = 0.009) and NPRS pain scores (OR = 0.79, p = 0.029). CONCLUSIONS: Postoperative satisfaction and expectation are independently associated with physical and mental health, gender and pain. Integrating these determinants into multidisciplinary care pathways would optimise patient outcomes and experience. Level of Evidence III.