Report on the Japanese Orthopaedic Association’s 3-year project observing hip fractures at fixed-point hospitals

The aim of this study was to assess the disability and mortality of hip fractures 1 ear after initial visit (postoperatively) at fixed-point hospitals selected by the Japanese Orthopaedic Association Committee on Osteoporosis. A total of 158 core orthopedic hospitals were selected for participation in this research. Subjects were all aged 65years and older with hip fractures at the selected hospitals between January 1, 1999 and December 31, 2001. A prognostic survey of activities of daily living (ADL), assessed by the long-term care insurance criteria established by the Ministry of Health, Labour, and Welfare of Japan was performed 1year after the initial visit. A total of 10 992 hip fractures in patients aged 65 to 111years were treated over the 3years from 1999 to 2001. Among the 10992 patients, 4537 had femoral neck fractures and 6217 had trochanteric fractures. Surgical treatment was chosen for 85.6% of the femoral neck fractures and 88.2% of the trochanteric fractures. The mean duration from fracture to admission was 3.1days, and the mean duration from admission to surgery was 11.2days. The mean duration from surgery to discharge over the 3-year period was 49.8days. Before hip fracture, the ratio of patients with J1 (“able to go out freely utilizing public transportation”) or J2 (“able to visit immediate neighbors independently”) on the long-term care insurance criteria was 50.9%. At 1year after the initial visit, that result represented a decrease of 24.1 percentage points before hip fracture. A total of 70 patients died before undergoing surgery. In the present study, the 1-year mortality rate for the entire patient population over the 3-year period was 10.1%. Hip fracture patients show a decrease in the ADL score 1year after the initial visit. Compared to other countries, the duration of hospitalization is longer in Japan, but the mortality rate is lower.