Incidence study on the outcomes of hip fractures over a 5 year period in the UK.

Abstract

Introduction

Hip fractures are a debilitating condition with increasing incidences in recent years in a growing ageing population. There are approximately 80,000 new cases annually in the UK. This major public health issue has an estimated annual cost of £1 billion, with many associated complications. 

Objective

To analyse the incidences of different surgical options, length of stay, and mortality rates over 5 years.

Method

Data was extracted from the National Hip Fracture Database, looking at hip fractures in patients aged ≥60 years in the UK. This included the most popular surgical procedure performed for different fracture types, the average hospital length of stay, and the average annual mortality rate, between 2016 to 2020 inclusive. Statistical analysis was performed with single factor ANOVAs and Tukey’s post-hoc testing.

Results

Over the 5 year period, the percentage of patients with an intracapsular fracture receiving cemented arthroplasty increased from 85.46% to 92.32%. The percentage of extracapsular fractures managed with sliding hip screws dropped from 78.38% to 69.17%. For patients with subtrochanteric fractures, the percentage treated with an intramedullary nail increased from 82.24% to 90.15%. In 2016 the average hospital stay was 16.47 days (SD = 0.34), which went down to 13.73 days (SD = 1.50) in 2020. There was no clear change in the annual mortality rates, with a range of 6.50-7.50% over the 5 year period.

Conclusion

The current surgical management for hip fractures has great outcomes when using the most popular surgical procedures, of which shorter length of stays and lower mortality rates play a vital role. Whilst the recent COVID 19 pandemic has had a heavy impact on the UK, the trends over the past five years show clear improvements in hip fracture outcomes.