Clinical Outcomes in Geriatric Hip Fracture Patients with and without Dementia Following Ground-Level Falls

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

People 65 years and older with hip fractures have high rates of morbidity and mortality after hospital discharge. The presence of dementia portends an even greater risk, highlighting the importance of early discussions of goals of care. The aim of this study is to examine clinical outcomes in patients with isolated hip fractures following ground level fall, with and without dementia, to aid in these discussions.

This retrospective study used medical records and trauma registry data from our institution, which is the highest volume Level 1 trauma center in the state for hip fractures. Patients aged 65 and older with isolated hip fractures from ground-level falls between January 1, 2018, and October 20, 2024, were included. Patient characteristics and outcomes were collected, and statistical analyses were conducted using SAS software (SAS Institute Inc.). A two-sided α level of 0.05 was used to determine statistical significance.

2121 geriatric trauma patients, 509 with dementia (mean age, SD: 85±6.8) and 1612 without dementia (mean age, SD: 80±8.6) were identified. 96.4% of the population was Caucasian, and 68% were female. Patients with dementia were more likely to be female, older, have higher baseline functional dependence (61.9% vs 47.4%; p< 0.0001), lower operative fixation rates (94.1% vs 96.2%; p< 0.05), and higher incidence of delirium (4.9% vs 2.7%, p< 0.05). Readmission at 30 and 90 days was lower (p< 0.03 and (p< 0.004) in the dementia group. Advance care planning discussions, DNR orders, and healthcare power of attorney documentation were all significantly higher amongst patients with dementia (all p< .0001). Patients with dementia were significantly more likely to have a hospice consultation and be discharged to hospice (p< 0.0001). Mortality rates were significantly greater for patients with dementia at all points assessed (in hospital, 30, 60, 90, 180, and 365-days post-discharge, all p< .0001).

Patients with dementia have higher mortality rates at all time points measured post-discharge than those without. These findings highlight the importance of early goals of care including discussing prognosis, patient preferences, and advanced care planning during hospitalization for this population. Multidisciplinary collaboration, including engaging Geriatrics as is routine at our institution, can be beneficial in guiding these important discussions.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1955

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