Preoperative EUROQOL-5-Dimension (EQ-5D) as a predictor of 1-Year Mortality in an intra-pandemic cohort of intra and extracapsular hip fracture patients.

Abstract

Quality of life is frequently measured pre-surgery in patients with hip fractures in order to serve as an aim to return to post-surgery. The EUROQOL-5 DIMENSION (EQ-5D) is a validated and reliable instrument for quantifying a patient's preoperative quality of life. The aim of this study is to investigate the correlation between preoperative EQ-5D and 1-year mortality in patients presenting with hip fractures. A retrospective study was conducted on all admitted hip fracture patients who underwent surgery in a single tertiary hospital between the period of 2020-2021. Variables collected include 1-year mortality, type of fracture, type of surgery, age, gender, ethnicity, and Charlson Comorbidity Index. The effect of these variables on 1-year mortality was then examined through binary logistic regression. There were 579 patients. The mean age was 79.54 ± 7.88 years. At 1-year post-operation, 92.4 % (535) of patients survived. EQ-5D was found to be a strong predictor of 1-year mortality in patients, which remained significant after adjusting for age, gender, ethnicity, type of surgery, type of fracture, and comorbidity in multivariable analysis (OR = 1.18, (95 % CI 1.07-1.30), p < 0.001). Data for preoperative EQ-5D was complete. Through this study, we concluded that poorer preoperative EQ-5D was associated with higher 1-year mortality in hip fracture patients. With earlier identification of patient groups at risk of higher 1-year mortality, more planning can be directed towards better management. Thus, preoperative EQ-5D is a useful predictor of 1-year mortality following hip fracture surgery.