Functional Outcomes and Mortality Predictors in Geriatric Hip Fracture Patients with Multiple Comorbidities: A One-Year Study at a Tertiary Care Centre in Western Gujarat

Background: Hip fractures in the elderly carry high morbidity and mortality, especially when several comorbidities are present, the risks rise sharply. In India, late presentations, delayed surgeries and a heavy burden of chronic diseases often lead to poorer results compared to Western countries. This study evaluated functional recovery and identified factors predicting mortality in such high-risk geriatric patients treated at a tertiary hospital in western Gujarat. Material and Methods: A prospective observational study was conducted for a year, at the Department of Orthopaedics and Medicine, at a tertiary care centre Gujarat. Patients aged ≥65 years presenting with lowenergy hip fractures and having at least two major comorbidities were included. Polytrauma, pathological fractures and patients refusing surgery were excluded. Data on demographics, comorbidities, Charlson Comorbidity Index (CCI), time to surgery, laboratory parameters and type of surgery were recorded. Follow-up was done at 3, 6 and 12 months for mortality and functional assessment using Modified Harris Hip Score (MHHS) and Parker Mobility Score (PMS) in survivors. Results: Of 138 patients enrolled (mean age 78.6 ± 8.2 years, 56% female), 61% had intertrochanteric fractures. Mean CCI was 5.4 ± 1.8 and mean delay to surgery 4.9 ± 3.1 days. In-hospital mortality was 9.4%, 30-day mortality 13.8%, and one-year mortality 27.5%. On multivariate analysis, independent predictors of one-year mortality were age >80 years (p=0.002), male gender (p=0.009), CCI ≥6 (p72 hours (p=0.004), serum albumin