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Understanding One-year Mortality Rates and Comorbidity Burden in Older Adults Following Hip Fracture
Journal article   Peer reviewed

Understanding One-year Mortality Rates and Comorbidity Burden in Older Adults Following Hip Fracture

Chris Sun, Eric R Tecce, Kimberly Dong, Alec M Giakas, William Ryan and Asif M Ilyas
Orthopedics (Thorofare, N.J.), pp 1-9
08 Jul 2026
DOI: https://doi.org/10.3928/01477447-20260608-01
PMID: 42412073
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Abstract

Hip fractures impose substantial patient morbidity and burden to health care systems globally, with potentially high and variable 1-year mortality rates. To improve shared decision making when guiding treatment for patients, this study evaluated 1-year mortality rates following hip fractures in the older adult population using a large multicenter live database. The study goal was to determine the recent 1-year mortality rate with contemporary orthogeriatric care strategies. A retrospective cohort study was conducted using the TriNetX Research Network. Patients aged 65 to 90 years with an incident hip fracture were identified, excluding those with same-day mortality or previous hip fractures. Cohorts were stratified by sex and 5-year age intervals. One-year all-cause mortality rates following hip fracture and Kaplan-Meier survival (KM) estimates, with log-rank tests, were calculated. Pre-fracture demographic and clinical characteristics were compared between those who succumbed within 1 year and those who survived beyond 1 year. Among 197,222 included patients, the 1-year mortality rate was 11.6%, with an 86.7% KM estimate of survival. One-year mortality increased with age and was higher in men across all age strata. Patients with 1-year mortality demonstrated a higher baseline comorbidity burden, including neurocognitive, cardiovascular, metabolic, renal, hepatic, and pulmonary diseases and malignancies. Although women succumbing within 1 year had higher rates of certain neurocognitive and metabolic disorders, men had higher rates of chronic ischemic heart disease and chronic kidney disease. One-year mortality following hip fractures was approximately 12%. Continued monitoring and optimization of multidisciplinary orthogeriatric models and postoperative care may further improve outcomes and survival.

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