Factors associated with frailty and the effect of frailty on postoperative outcomes in older adults with hip fracture

Q: What is the purpose of the study on frailty and hip fracture?

To examine the relationship between prefracture frailty and postoperative patient outcomes, and to identify factors associated with frailty in older adults undergoing hip fracture surgery.

Q: How were participants and data collected?

Patients aged 65 and older who underwent hip fracture surgery were included. Data were gathered through face-to-face interviews with patients in their rooms preoperatively and on the first postoperative day.

Sep 30, 2026

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Hip fractures are rising with population aging and remain a major global health concern because of high mortality. This study investigates how prefracture frailty relates to postoperative outcomes and identifies frailty-associated factors in older adults undergoing hip fracture surgery. A descriptive cross-sectional design enrolled patients aged 65+; data were collected by face-to-face interviews preoperatively and on the first postoperative day. Frailty correlated with multiple clinical and postoperative outcomes, with nutritional status and functional independence predicting frailty.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

Methods

Results

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ORIGINAL ARTICLE Factors associated with frailty and the effect of frailty on postoperative outcomes in older adults with hip fracture Çiğdem Kaya,1 Özlem Bilik,2 Yılmaz Kaya,3 Serdar Sever4 1Department of Surgical Nursing, Faculty of Health Sciences, Balıkesir University, Balıkesir-Türkiye 2Department of Surgical Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir-Türkiye 3Orthopedics and Traumatology Clinic, Balıkesir State Hospital, Balıkesir-Türkiye 4Department of Nursing, Faculty of Health Sciences, Usak University, Usak-Türkiye ABSTRACT BACKGROUND: The incidence of hip fractures is also increasing rapidly with the aging population and is currently considered a major significant global health issue due to its high mortality rate. The aim of this research is to investigate the relationship between prefracture frailty and postoperative patient outcomes and identify factors associated with frailty in older adults operated for hip fracture. METHODS: Descriptive, cross-sectional study. Patients aged 65 and older who underwent surgery for hip fracture were included. Data were collected in face-to-face interviews with patients in their rooms preoperatively and on the first postoperative day. The study was approved by the non-interventional research ethics committee of Dokuz Eylul University. Data analysis was performed using descriptive statistics, independent samples t-test, One Way ANOVA, correlation, and multiple linear regression analyses. RESULTS: Of the 128 patients included in the study (mean age 78.45±8.36 years), 46.1%(n=59) were prefrail, and 39.8%(n=51) were frail. Higher frailty scores were associated with female sex, chronic disease, use of multiple long-term medications, being immobile or requiring mobility assistive devices prior to the fracture, recent decrease in appetite, need for postoperative intensive care, postoperative complications, postoperative pressure injury development, and mortality within the first month of discharge (p<0.05). Preoperative frailty score was positively correlated with number of chronic diseases, preoperative fear of falling, nutritional risk score, comorbidity index score, and length of hospital stay and negatively correlated with preoperative and postoperative Katz ADL score and postoperative creatinine concentration(p<0.05). The mean Frailty Scale score was 2.16±1.26; pre-fracture nutritional status (β=0.312, p<0.001) and functional independence status (β=0.216, p=0.012) were significant predictors of frailty. CONCLUSION: This study showed that frailty was prevalent among older adults undergoing hip fracture surgery and had a significant impact on postoperative patient outcomes. Pre-fracture nutritional and functional status were significant factors associated with frailty. Preoperative frailty assessment of patients presenting with hip fractures, especially focusing on nutritional and functional status, may contribute to better management of treatment and care. Keywords: Aging; frailty; hip fracture surgery. INTRODUCTION Due to demographic aging, the prevalence of frailty is expected to increase significantly. Frailty impacts 70% of older adults,[1] increasing the risk of functional decline and dependency.[2] Frailty encompasses issues such as cognitive impair- ments, delirium, urinary incontinence, malnutrition, falls, gait disturbances, pressure injury, sleep disorders, sensory deficits, fatigue, and dizziness.[3] These problems are common among older adults and result in significant disability and impaired quality of life.[1,4] Cite this article as: Kaya Ç, Bilik Ö, Kaya Y, Sever S. Factors associated with frailty and the effect of frailty on postoperative outcomes in older adults with hip fracture. Ulus Travma Acil Cerrahi Derg 2025;31:1055-1064. Address for correspondence: Çiğdem Kaya Department of Surgical Nursing, Faculty of Health Sciences, Balıkesir University, Balıkesir, Türkiye E-mail: [cigdemkaya701@gmail.com](cigdemkaya701@g

FAQs

What is the purpose of the study on frailty and hip fracture?

To examine the relationship between prefracture frailty and postoperative patient outcomes, and to identify factors associated with frailty in older adults undergoing hip fracture surgery.

How were participants and data collected?

Patients aged 65 and older who underwent hip fracture surgery were included. Data were gathered through face-to-face interviews with patients in their rooms preoperatively and on the first postoperative day.

Which factors were associated with higher frailty scores?

Higher frailty scores were associated with female sex, chronic disease, use of multiple long-term medications, immobility or need for mobility assistive devices before the fracture, recent decrease in appetite, need for postoperative intensive care, postoperative complications, development of postoperative pressure injury, and mortality within the first month of discharge.

Sep 30, 2026

Uploaded by CatatanPagi