Prevalence and Predictors of Hip Fragility Fractures Related Mortality Following Hip Surgery At a Tertiary Medical Centre Based in Sub Saharan Africa

Abstract

Background: Fragility hip fracture not only is common among patient above 50 years who sustain fracture but also it is associated with very high mortality within 1 year post hip surgery. Moreover factors predicting mortality can be identified before hip surgery, modified and reduction of mortality can be achieved to our patients following hip fracture surgery. Objective: We conducted a cross sectional analytical study which aimed at determining the prevalence and factors predicting early mortality among patients with fragility hip fractures who underwent the hip surgery at Kilimanjaro Christian Medical Centre ( KCMC) from January 2017 to April 2022 Methods and Materials Participants were selected by convenience sampling technique, all patients admitted with hip fractures at Kilimanjaro Christian Medical Centre (KCMC) who met the inclusion criteria during the study period were recruited. The data were collected from patients’ medical files and Electronic Health Management System (EHMS) using a structured questionnaire and were processed and analyzed using SPSS version 27. Results: The prevalence of fragility hip fracture was 4.24% among 6521 admitted trauma patients at Kilimanjaro Christian Medical Centre (KCMC) during the study period. Male were predominant gender. 81.10% of patient were operated late; main reasons of delay were payment and comorbidities. Mortality within one year was 24.70% most death occurred within 3months accounting for 64.1%. Among the factors analyzed, the following variables showed statistically significant associations with mortality among patients who underwent surgical treatment for hip fragility fractures: Patients with Health Insurance had a significantly lower odds of death compared to those paying with cash (odds ratio = 0.08, 95% CI: 0.01 - 0.84). Patients with a higher Charlson Comorbidity Index (CCI) above and moderate score (3-4) had significantly higher odds of death compared to those with a mild score (1-2) (odds ratio = 7.70, 95% CI: 1.03 - 57.49). `Patients with higher ASA scores (ASA2) had significantly higher odds of death compared to those with ASA1 (odds ratio = 7.70, 95% CI: 1.03 - 57.49). Conclusion Mortality within 1-year was very high. Most patients died within 3 months post-surgery. Most of our patient were operated late, payment and comorbidities were the main reasons of delaying hip surgery at our setting