THIRTY-DAY MORTALITY OUTCOMES IN ELDERLY PATIENTS WITH PROXIMAL HIP FRACTURES TREATED AT A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL STUDY USING THE NOTTINGHAM HIP SCORE

Authors

Rajeevratna Suresh Naik , Sachin L ,Basava Kiran J K , Pramod V Patil Author

Keywords:

Proximal hip fracture, elderly, 30-day mortality, Nottingham Hip Score, trochanteric fixation nails, surgical intervention, intertrochanteric fractures, femoral neck fractures, functional recovery, comorbidities, hypertension, diabetes, postoperative complications

Abstract

Introduction And Aim : Proximal hip fractures in the elderly are associated with
high morbidity, mortality, and a substantial healthcare burden due to functional
decline and prolonged recovery. With an increasing incidence driven by global aging,
understanding early outcomes such as 30-day mortality is vital for evaluating
perioperative care quality. This observational study investigates the 30-day mortality
rate in elderly patients with proximal hip fractures treated at a tertiary care hospital,
utilizing the Nottingham Hip Score (NHS) as a prognostic tool. By examining the
correlation between NHS and early mortality, the study aims to enhance risk
stratification and inform targeted interventions to improve outcomes in this high-risk
population.
Materials And Methodology : This prospective observational study was conducted
at a tertiary care hospital to evaluate 30-day mortality in elderly patients (≥60 years)
with proximal hip fractures, using the Nottingham Hip Score (NHS) as a predictive
tool. The study included patients with femoral neck, intertrochanteric, or
subtrochanteric fractures who underwent surgical or conservative treatment.
Exclusion criteria included pathological fractures from malignancies, polytrauma,
terminal illness with life expectancy under 30 days, and loss to follow-up. Data
collected included patient demographics, comorbidities, fracture type, injury
mechanism, preoperative assessments (including NHS and ASA classification),
treatment modality, complications, and 30-day mortality outcomes. The primary
endpoint was 30-day mortality.
Conclusion : This observational study examines the burden of proximal hip fractures
in the elderly, revealing a predominance among older females with common
comorbidities such as hypertension and diabetes. Intertrochanteric fractures were the
most frequent, with intramedullary fixation using trochanteric fixation nails (TFN)
being the preferred surgical approach. Despite modern fixation techniques, functional
recovery—as assessed by the Nottingham Hip Score—remained limited,
underscoring the multifactorial challenges in managing this frail patient population.