Ömer YONGA, Mehmet Özgur ERDOĞAN
Global Emergency and Critical Care - 2026;5(2):106-113
Objective: This study aimed to identify predictors of in-hospital mortality among geriatric patients presenting with acute hip fracture. Materials 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 performed 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 differences 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-energy 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 derangement, and electrolyte abnormalities. Simple parameters available in the emergency department may facilitate rapid risk stratification and guide early management.
