Hip fracture in elderly men: prognostic factors and outcomes

Med J Aust. 1997 Oct 20;167(8):412-5. doi: 10.5694/j.1326-5377.1997.tb126646.x.


Objective: To examine prognostic factors and outcomes after hip fracture in men aged 60 years and older.

Design and setting: Cohort study of all men presenting to St George Hospital (a 650-bed tertiary care centre) with hip fractures in 1995, recruited retrospectively from medical records and evaluated prospectively at six and 12 months after fracture.

Patients: 51 men aged 60 years or more (and, for comparison, 51 age-matched women) who presented with hip fracture not caused by high impact injuries or local bone disease.

Main outcome measures: Prognostic factors (such as pre-existing illness and osteoporotic risk factors) and outcome data (such as fracture-related complications, mortality, and level of function as measured by the Barthel index of activities of daily living at six and 12 months postfracture).

Results: Median age of the 51 men was 80 years (interquartile range, 74-86 years); four were aged under 70 years. Outcome assessment was possible for 41 men (80%). Similar proportions of men and women came from institutions (32% v. 28%), and similar additional proportions required institutionalisation after discharge (18% v. 14%). Fracture-related complications affected similar proportions of men and women (30% v. 32%), and mean length of hospital stay was similar. Fourteen per cent of men died in hospital compared with only 6% of women (P = 0.06). Men had more risk factors for osteoporosis (P < 0.01). Physical functioning (measured by the Barthel index) deteriorated significantly in men from 14.9 at baseline to 13.4 at six months (P < 0.05) and 12.4 at 12 months (P < 0.05) after fracture.

Conclusion: Compared with women, elderly men presenting with hip fracture have higher mortality and have more risk factors for osteoporosis. Like women with hip fracture, men are usually fragile, with pre-existing medical illness and fracture-related complications contributing to their overall poor outcomes.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cohort Studies
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Hip Fractures / epidemiology*
  • Hip Fractures / mortality
  • Hip Fractures / surgery
  • Humans
  • Incidence
  • Male
  • New South Wales / epidemiology
  • Osteoporosis / epidemiology
  • Postoperative Complications / epidemiology
  • Prognosis
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Treatment Outcome