Impact of orthogeriatric assessment on mortality in patients with periprosthetic hip fractures: a prospective study.

BACKGROUND

Periprosthetic hip fractures (PPHF) are a serious and increasingly frequent complication of hip arthroplasty, associated with significant morbidity and mortality in older adults. AIMS: To investigate the association between orthogeriatric assessment scores and six-month and one-year postoperative mortality in elderly patients undergoing surgery for PPHF.

METHODS

A prospective registry of patients aged ≥ 65 years treated surgically for PPHF at Trieste University Hospital was analysed. Clinical, radiographic, and perioperative data were collected. Orthogeriatric scores, including the Mini Nutritional Assessment – Short Form (MNA-SF), Short Portable Mental Status Questionnaire (SPMSQ), Activities of Daily Living (ADL), Charlson Comorbidity Index (CCI), Parker Mobility Index, and Nottingham Hip Fracture Score (NHFS), were recorded on admission and at follow-up. Univariate analyses were performed to identify predictors of six-month and one-year mortality.

RESULTS

Fifty-two patients (mean age 83.6 ± 8.1 years; 77% women) were included. The six-month and one-year mortality rates were 23.1% (12/52 patients) and 22.5% (9/40 patients), respectively. Higher mortality correlated significantly with poorer nutritional status (MNA-SF, p = 0.033; p = 0.011), lower cognitive performance (SPMSQ, p = 0.004, p = 0.002), reduced functional independence (ADL, p = 0.041, p = 0.026), and higher Nottingham Hip Fracture Scores (NHFS, p = 0.022, p = 0.047).

CONCLUSIONS

In conclusion, orthogeriatric scores, particularly MNA-SF, SPMSQ, ADL, and NHFS, are strong predictors of mortality after PPHF.