A retrospective cohort study comparing outcomes following hip fractures in Australian indigenous patients with non‐Australian indigenous patients

Background Australian Indigenous (AI) populations face significant socioeconomic disadvantage and have poorer health outcomes when compared to their non‐AI counterparts. There is a paucity of published literature on outcomes following hip fracture in the AI population. Methods We performed a retrospective cohort study comparing outcomes following hip fracture in AI and non‐ AI patients presenting to a single regional trauma centre. The primary outcome of interest was all‐cause mortality. Secondary outcomes of interest were the odds of postoperative delirium and length of stay in hospital. All outcomes were adjusted against collected baseline covariates. Results One hundred and twenty‐seven hip fractures were identified across 125 patients. There were 62 hip fractures in the AI group and 65 in the non‐AI group. The adjusted hazard ratio (HR) for all‐cause mortality was not statistically significant when comparing Indigenous versus non‐Indigenous patients (HR = 2.37, P = 0.055). Adjusted odds of postoperative delirium was lower in Indigenous patients (OR = 0.12; P = 0.018). The AI cohort had a 4 day longer median length of stay, which was not statistically significant when adjusted for covariates. Conclusion AI patients with hip fractures were younger, had a higher Charlson Comorbidity Index Score and American Society of Anaesthesiologists grade, as well as a higher incidence of diabetes and associated end‐organ sequalae. There was no difference in all‐cause mortality. Odds of postoperative delirium was lower in the AI group. We did not find any difference in the length of hospital stay. We have performed a longitudinal cohort study investigating the differences in all‐cause mortality, postoperative delirium and length of hospital stay following hip fracture in Australian Indigenous and non‐Australian Indigenous patients presenting to our institution. In this study, we have concluded there were no differences in all‐cause mortality or length of stay in hospital. However, odds of postoperative delirium was lower for the Australian Indigenous group.