Mortality after Hip Fracture in Diabetic Patients

Aim: Type 2 diabetic patients have an increased incidence of hip fracture. In this study, we aimed to evaluate the mortality rate after hip fracture and determine the predictors of mortality in diabetic patients. Methods: 356 patients who sustained a hip fracture between January 1997 and June 2008 were retrospectively reviewed for the study. Of the eligible 230 patients, 69 had type 2 diabetes. Each of these patients' medical and nursing notes were reviewed to ascertain additional information, including patient demographic factors, prior co-morbidities, fracture type, length of post-fracture stay and post-operative complications, the presence and duration of diabetes, glucose levels, HbA1c levels, albumin and hemoglobin levels. Results: 148 women (64.3%) and 82 men (35.7%) were included in the study. The mean age of the study group was 76.1 +/- 10.4 years. The mean age for diabetics was 76.1 +/- 12.0 years and was 75.1 +/- 9.4 years for non-diabetics (p = 0.343). Diabetic patients with hip fracture had a higher risk of mortality than the non-diabetic patients. One year survival probabilities of diabetic and non-diabetic patients were respectively 68.0% and 87.3% (p=0.033). In diabetic patients with a hip fracture, predictors of mortality were advanced age, the presence of postoperative complications and elevated HbA1c levels. Conclusions: Diabetic patients have an increased risk of mortality after hip fracture. The medical care in the post-operative period, including glycemic control and postoperative complications, should be optimized in diabetic patients suffering from hip fracture in order to decrease mortality in these patients.