Outcomes post hip fracture for patients with COPD

Introduction: Hip fractures are prevalent in patients with COPD, but contemporary data on outcomes are required. Methods: All admitted patients with a hip fracture at a large Trauma Centre are audited and mortality calculated through linkage with the Office for National Statistics. In addition to the National dataset, co-morbidity (including COPD diagnosis) and complications are recorded. Cases between Oct 2010 and Oct 2015 were retrieved. Baseline variables were compared according to COPD diagnosis. Multivariate logistic regression was used to explore the associations between COPD, complications (chest infection) and mortality. Results: 4020 patients were included of which 651 (16%) had COPD. The median age was lower and there were more men with COPD; far fewer (39%) received a general anaesthetic compared to non-COPD (59%), and they carried twice the risk of developing a chest infection (adjusted odds ratio (aOR) 2.44, 95% CI 1.96-3.04). Mortality was greater compared to non-COPD with the proportion dead at 30-days (12.6% vs 7.8%) and 1-year (35.3% vs 25.3%) giving aOR for mortality of 1.69 (95% CI 1.28-2.23) and 1.44 (95% CI 1.18 -1.76) respectively; these had not changed significantly from the preceding 5 years (2005-2010). Figure below. Conclusions: Hip fracture in the context of COPD continues to carry significant mortality with 35% dead at 1 year. Therefore, all preventative endeavours to reduce hip fractures are paramount in this high-risk group.