Introduction: Hip fractures are common amongst the elderly, often with serious consequences and increased mortality. The aim of this study was to describe treatment and outcome of patients with hip fractures.

Material and methods: Retrospective study on all hip fracture patients ≥60 years of age operated at Landspitali University Hospital in the year 2011.

Results: The study group was made up of 255 patients (mean age 82 ± 8 years, women 65%). Mean delay to operation was 22 ± 14 hours. Mean length of hospital stay for those living at a nursing home before hip fracture was 4 ± 2 days but if they had lived at home 14 ± 10 days (p<0.001). Before the fracture 68% of the patients lived at home but 54% at the end of follow-up (p<0.001). Mortality one year after hip fracture was 27% and on average eightfold compared to the general population ≥60 years. A multivariate analysis showed that age, time from fracture to arrival at hospital, ASA-classification and living in a nursing home before fracture were linked to an increased risk of death.

Conclusion: The mean delay to surgery was within recommended guidelines, but one- third waited longer than 24 hours. Resources outside hospital seemed to decide hospital length of stay. Mortality of hip fracture patients was manifold compared to the general population of the same age and within higher range compared to other countries. Significantly fewer lived in their own home after the fracture. Hip fractures cause serious debilitation and are demanding for society.

Figure 1. Residency and mortality ratio of patients before and after hip fracture. Number of patients within each ratio is shown in the columns. Other level of care: Another ward within Landspitali University Hospital, geriatric ward, other hospital, patient hotel. Of those that died within one year after fracture 40 (49% mortality) lived in a nursing home before the fracture but 29 (17% mortality) at home. Information of residency was lacking for a few patients, therefore the total number of patients is not 255 in all the columns.

Figure 2. Mortality of hip fracture patients according to age groups at end of follow up which was in mean 2 years

Figure 3. Survival of hip fracture patients in days from the operation.

Figure 4. One year mortality of hip fracture patients compared to the mortality in the general population in Iceland of the same age year 2011, in age groups of ten years. The number of patients in each age group is presented above the columns.

Table I.  Mean age, gender ratio and mortality at 30 days and one year of hip fracture patients in Iceland in comparison with studies from other countries.