JAAOS - 2026-05-15 - Journal Article
Mortality Trends Following Geriatric Hip Fractures in New York State Between 2010 and 2019: An Examination of the New York Statewide Planning and Research Cooperative System Database.
Anil U, Lin CC, Trudeau MT, Ganta A, Egol KA, Konda SR
Topics
Key Takeaway
3-month mortality after geriatric hip fracture in New York State fell from 10.8% in 2010 to 8.6% in 2019, with Cox regression confirming significantly reduced hazard ratios from 2012–2019 versus 2010 across 142,540 patients.
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Summary
This study queried the SPARCS database for patients ≥65 years with femoral neck or intertrochanteric fractures from 2010–2019 to characterize mortality trends over time. Kaplan-Meier analysis showed 3-month mortality declined from 10.8% to 8.6% and 12-month mortality declined from 17.7% to 14.8% by 2018, though 12-month mortality rebounded to 16.9% in 2019. Secondary outcomes also improved: LOS decreased from 7.8 to 6.4 days, 3-month readmissions from 34% to 22%, and 3-month ED visits from 45% to 34% (all P<0.001).
Key Limitation
The SPARCS database is limited to New York State, and the absence of operative details—including time-to-surgery, fixation construct, and anesthesia type—prevents attribution of mortality trends to any specific clinical intervention.
Original Abstract
OBJECTIVES
Increased mortality following geriatric hip fractures is well reported. However, population-level analysis of mortality trends over time are not common. This study aimed to evaluate the 3- and 12-month mortality after geriatric hip fractures from 2010 to 2019.
METHODS
The New York Statewide Planning and Research Cooperative System database from 2010 to 2020 was retrospectively queried for patients aged >65 years with a femoral neck or intertrochanteric hip fracture. Kaplan-Meier survival analysis was used to calculate mortality rates for each year. Cox proportional hazard multivariable regression controlling for sex, age, race, obesity, smoking, and Elixhauser comorbidity index was used to compare mortality hazard ratios for each year. Secondary outcomes included length of stay, discharge disposition, and 3-month readmission and emergency department visits.
RESULTS
From 2010 to 2019, 142,540 patients aged ≥65 years had a diagnosis of femoral neck fracture (62%) or intertrochanteric hip fracture (38%). The mean age was 83.29 years (SD 8.22). The mean Elixhauser comorbidity index was 7.35 (SD 7.60). Kaplan-Meier survival analysis revealed that for the complete cohort 3-month mortality rate was 9.82% (95% confidence interval 9.65% to 9.98%) and 12-month mortality rate was 16.06% (95% confidence interval 15.84% to 16.27%). The 3-month mortality rate went from 10.8% in 2010 to 8.6% in 2019 and the 12-month mortality rate went from 17.7% in 2010 to 14.8% in 2018 before rising to 16.9% in 2019. Cox multivariate proportional hazard regression demonstrated statistically significant decreased hazard ratio from 2012 to 2019 compared with reference hazard in 2010 (all P < 0.05). Reductions were also observed for length of stay (7.8 to 6.4 days, P < 0.001), 3-month readmissions rate (34% to 22%, P < 0.001), and 3-month emergency department visit rate (45% to 34%, P < 0.001).
CONCLUSION
Mortality after geriatric hip fractures has demonstrated a reduction in the past decade with 3-month mortality continuously decreasing from 2010 to 2019 and 12-month mortality decreasing from 2010 to 2018 before increasing in 2019.