wetenschapsdag 2023 | 111 Best Abstract Sessie x3 Auteurs H.E. van Bremen, L.J. Seppala, J. H. Hegeman, N. van der Velde, H.C. Willems; Dutch Hip Fracture Audit Group* Abstract titel Characteristics and outcomes of non-operatively managed hip fracture patients using the Dutch Hip Fracture Audit (DHFA). Background Considering the growing number of hip fracture patients, prioritizing patient-centred hip fracture care is important. Given the increasing awareness of nonoperative management as a treatment option in frail patients, the need for understanding the characteristics of the non-operatively treated population is growing. This study aims to compare and identify patient- and fracture characteristics in hip fracture patients treated nonoperatively and patients treated operatively. Methods This retrospective population-based cohort study used data from a nationwide hip fracture database. All adult patients sustaining a hip fracture between 2016-2022 in the Netherlands were included. Patients with pathological or periprosthetic hip fractures were excluded. Data were analyzed in 2023. Patients were categorized according to the type of management (operative vs nonoperative). Primary outcomes were patient- and fracture characteristics associated with nonoperative management. Univariate and multivariable analyses were used to identify clinical characteristics independently associated with nonoperative management. All-cause mortality was measured at seven days, 30 days, three months and one year. Results A total of 94.930 hip fracture patients were included, with an incidence of nonoperative management of 3.2%. Patients receiving nonoperative management were older (86 years [interquartile range 79-91] vs 81 years [interquartile range 72-87] P <.001), more frequently institutionalized (42.4% vs 17.6%), had poorer mobility and were more dependent in activities of daily living. Various clinical characteristics, including dementia (odds ratio 1.31 [95% confidence interval, 1.18-1.45] P < .001), no functional mobility (odds ratio 4.39 [95% confidence interval 3.14-3.68] P <.001), and KATZ-6-ADL (OR 1.17 [95% CI 1.14-1.20] P < .001) were independently associated with nonoperative management. 7-day mortality was 37.6%, and 30-day mortality was 57.1%.
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