Abstract
Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians and those aged 65 years to 89 years. Demographics, comorbidities, fracture type, surgical management, mortality, and survivorship were collected. Chi-square testing with Bonferroni correction was used for statistical comparisons. Results: The mean age was 93 years in the nonagenarian cohort and 72 years in the younger cohort. Nonagenarian individuals experienced similar in-hospital mortality rates (6.25% vs 1.10%; Odds Ratio [OR] 6.0; 95% Confidence Interval [CI] 0.65 – 55.0; P > 0.05). Survival was significantly lower for nonagenarians at three months (78% vs. 97%; OR 0.10; P < 0.05), six months (67% vs. 95%; OR 0.10; P < 0.05), and one year (58% vs. 95%; OR 0.08; P < 0.05). No significant differences were found in fracture type, surgical approach, discharge location, or one-year readmission rates. Conclusion: Nonagenarians experience substantially higher mortality and markedly reduced survivorship following hip fracture surgery compared with younger elderly patients. These findings underscore the importance of multidisciplinary perioperative care and comprehensive geriatric assessment to optimize outcomes in this vulnerable population.
Recommended Citation
Austin, Roman; Julio Avila; Audrey Wassef; Kate Parker; and Katherine Gavin. "Increased Mortality and Reduced Survival in Nonagenarians with Hip Fractures: Implications for Geriatric Care." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/9