Aims
Anecdotal clinical observations in the Gold Coast Hospital and Health Services suggested a difference in care between patients presenting with low trauma hip fracture depending on whether they were over or under 65 years. The aim of the current study was to compare hip fracture care between patients aged 50-64 or over 64.
Methods
A retrospective audit of hospital patient records from 2020 was conducted to extract data for patients aged over 50 with surgical treatment for hip fracture. Patient age, sex, history of fragility fracture, presence of risk factors, mechanism of injury, fracture classification, procedure classification, time to surgery, history of falls, mobility status, post-surgical weightbearing orders, time to first mobilisation, rehabilitation, specialist falls assessment, and bone protection medications on discharge were extracted. Data were compared between age groups using parametric and non-parametric tests.
Results
Sixty-four patients, 48 women (75%) and 16 men (25%), were included, group-matched for age, sex and date of admission. There were no differences in patient characteristics between age groups except for predominant preadmission mobility status which was ‘unaided’ in younger patients (62.5%) compared with ‘two aids or frame’ in older patients (43.8%) (p=0.016). Younger patients (31.3%) were more likely to receive a total hip replacement (THR) than older (8.3%) (p=0.025), and there was a trend for faster mobilisation in younger patients (1.7 days) than older (3.1 days) (p=0.065). There was also a trend for younger patients to be prescribed only calcium and/or vitamin D on discharge (43.8%) compared to older patients who were most often prescribed antiresorptives or teriparatide (56.5%) (p=0.052).
Conclusions
Younger patients were more likely to receive a THR, be mobilised earlier, and be prescribed only calcium and/or vitamin D on discharge than older patients. Older patients were more likely to be prescribed bone protective medicine on discharge than younger patients.