165 Prior Fracture Physical Dependence, Co-Morbidity and One-Year Survival of HIP Fracture Patients; Data from A HIP Fracture Registry in Sri Lanka

Hip fractures are associated with high mortality and morbidity. Many factors, before and after fracture, are linked with the survival of hip fracture patients. We analyzed the association between the one-year mortality and co-morbidity and physical dependence before fracture. Methods We used follow up data of Hip fracture registry maintained since September 2017. All patients with incident fragility hip fracture admitted to a tertiary care center in the Southern province of Sri Lanka were included and followed up. Information on co-morbidity (Age-adjusted Charlson co-morbidity index) was collected from previous records and interviews of patients and relatives. Barthel index-Sinhala version was used to collect information on physical dependence one week before fracture. Results Of 180 patients (149 women) followed up, 33 died within one year (mortality rate = 18%). Patients who survived were younger (mean age 75.6 vs 83.4ys, p < 0.001) and had lower co-morbidity (mean Age adjusted Charlson co-morbidity index 4.9 vs 6.3, p < 0.001) and higher Barthel index before fracture (97.4 vs 94.2, p = 0.001) when compared with those who died. Areas under curve (AUC) in the ROC analysis were 0.77 (SE 0.04, p < 0.001) for age, 0.79 (SE 0.04, p < 0.001) for co-morbidity and 0.67 (SE 0.05, p 0.003) for Barthel index. Conclusions Age, co-morbidity and prior fracture physical dependence are significantly associated with one-year survival of fragility hip fracture patients. This information can be used in early identification of patients who need special attention during the post-fracture follow up.