Mortality after admission to hospital with fractured neck of femur: database study

The death rate within one year of fractured neck of femur is typically reported as between 20% and 35%.1–3 Performance indicators based on mortality after hospital admission for such fractures have been promoted.4 The only measure of mortality in routine hospital statistics, however, is “in-hospital mortality”—death during the initial admission for the fracture. We analysed inpatient statistics that had been linked to death registration data in the former Oxford NHS health region (population 2.5 million) from 1994 to 1998. We selected emergency admissions in people aged 65 years and over who had been admitted to eight main acute trusts and for whom fractured neck of femur was the principal diagnosis (international classification of diseases, ninth revision (ICD-9), codes 820, 821.0, and 821.1). We calculated standardised mortality ratios after fracture by applying the age and sex specific mortality in five-year age groups in the whole population of the region (“standard” …