A Review of Hip Fracture Mortality—Why and How Does Such a Large Proportion of These Elderly Patients Die?

As the number of aged patients presenting with hip fractures continues to rise [1], the substantial mortality associated with this pathology must continue to be an area of scrutiny and improvement. While some dismiss the high mortality as an inevitable consequence of the comorbidities inherent in the original injury and the patient population, data suggest that at 2 years post-hip fracture, survivors’ risks have regressed significantly and in fact, return to the same mortality risk as the non-fracture population [2]. This indicates that the risk of death is largely created specifically by the hip fracture and its treatment per se rather than the comorbidities of the hip fracture population, and offers scope for the potential reduction of these causes of death if we can identify and manage them appropriately. At a time when the incidence of hip fracture worldwide is on a steady rise, this review considers why and how these older patients die, and whether our developing guidelines and continuing research is adequately addressing these causes of death.