Objective: This study aimed to identify predictors of in-hospital mortality among geriatric patients presenting with acute hip fracture.
Material and Methods: This retrospective cohort study included consecutive patients aged ≥65 years with radiologically confirmed proximal femoral fractures who presented to a tertiary emergency department between January 2020 and January 2025. Demographic characteristics, comorbidities, functional status, laboratory parameters, trauma characteristics, fracture patterns, and in-hospital complications were recorded. Univariable and multivariable logistic regression analyses were per-formed to identify independent predictors.
Results: A total of 833 patients were included (mean age 83.6±7.1 years; 64.9% male). The in-hospital mortality rate was 9.1%. Compared with survivors, non-survivors had poorer baseline function (ADL 3 vs. 4; IADL 4 vs. 5), a higher comorbidity burden (CCI 9 vs. 7), and greater physiological instability (NEWS2 4 vs. 3). Laboratory differ-ences were notable, with significantly lower serum sodium levels (134 vs. 138 mmol/L) and higher creatinine levels (1.4 vs. 0.9 mg/dL) among non-survivors. High-en-ergy trauma was more frequent among patients who died (14.5% vs. 6.2%). In the multivariable model, higher BMI (aOR 1.11; 95% CI 1.03–1.20), an increased Charlson Comorbidity Index (aOR 1.22; 95% CI 1.05–1.40), higher NEWS2 scores (aOR 1.51; 95% CI 1.33–1.73), and lower serum sodium levels (aOR 0.76; 95% CI 0.70–0.82) were independently associated with increased mortality, whereas DVT/PE showed a strong but statistically non-significant trend toward higher risk.
Conclusion: Early mortality in geriatric patients with hip fracture presenting to the emergency department is primarily driven by comorbidity burden, physiological de-rangement, and electrolyte abnormalities. Simple parameters available in the emergency department may facilitate rapid risk stratification and guide early management.
Keywords: Aged, emergency service, hospital, hip fractures, mortality, risk factors
