Palliative care in fragility hip fracture: An empirical narrative review of an underrecognised need.

BACKGROUND

Fragility hip fractures are associated with high morbidity, mortality, and complex care needs that extend beyond acute management. Despite this, palliative care remains underutilised in this population. Consequently, palliative care needs in people with fragility hip fractures remain insufficiently recognised, assessed and integrated into care pathways.

OBJECTIVE

To identify, synthesise, and analyse key concepts emerging from the literature on palliative care in fragility hip fractures, with a focus on their interrelationships and implications for care.

METHODS

An empirical narrative review with a structured search was conducted in MEDLINE, Scopus, CINAHL and Google Scholar for articles addressing palliative care and patients with fragility hip fractures, between 15 January and 10 February 2026. Eligible studies included meta-analyses, systematic reviews, observational studies, case series, books and case reports, published in Portuguese, English and Spanish within the last 5 years.

RESULTS

Of the 876 studies screened, 4 were included, adhering to the PRISMA flow diagram. The results suggests that patients with fragility hip fractures may have substantial palliative care needs, particularly in relation to symptom management, functional decline, and psychosocial support. However, timely identification of these needs and referral to palliative care services appears to remain limited.

CONCLUSIONS

In light of the limited evidence in integration of palliative care in the management of fragility hip fractures, an interdisciplinary approach embedding palliative care principles within orthogeriatric and fracture care pathways appears necessary. This should include adequately trained nurses to ensure comprehensive care and to support the quality of life of patients and their families.