ArticleIrish journal of medical science2026
Comparing clinical outcomes and mortality rates of patients who sustained hip fractures managed non-operatively versus operatively over a 5-year period across the Republic of Ireland.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHip fractures are a significant public health concern affecting millions of patients globally, particularly elderly and osteoporotic patients. The management of this injury is typically surgical in order to facilitate early mobilization; however, a small subset of patients is managed non-operatively.
aimsThe aims of this study were to evaluate patients with hip fractures managed non-operatively in Ireland to determine their clinical outcomes and mortality rates post-injury.
methodsA retrospective cohort study using data from the Irish Hip Fracture Database (IHFD) from 2017 to 2021 was carried out. The primary outcome was 30-day mortality, with secondary variables including admission source, gender, age, pre-injury outdoor mobility, pressure ulcer development, hospital length of stay, and discharge destination.
resultsAmong 15,427 patients, 3% received non-operative care (n = 405). Mortality at 30 days was significantly higher in hip fracture patients managed non-operatively (21% versus 4%; p < 0.001). Displaced intracapsular and subtrochanteric fractures were associated with higher mortality, while periprosthetic fractures were associated with survival (relative risk 2.57 and 2.55, respectively, p < 0.001 versus RR 0.09 p < 0.001). Independent pre-fracture mobility was also associated with survival in non-operatively managed patients (RR 0.32 p < 0.001).
conclusionsNon-operative management of hip fractures is associated with significantly higher mortality rates compared to surgical intervention at 30 days post-injury. Fracture morphology in the form of unstable patterns including displaced intracapsular and sub-trochanteric fractures are negative prognostic factors for such patients managed non-operatively, whilst independent pre-fracture mobility was correlated positively with post-injury clinical outcomes.
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