Mortality and serum urea and electrolytes on admission for hip fracture patients

OBJECTIVE: To assess the relationship between pre-operative serum urea and electrolyte concentrations and mortality in patients with hip fractures requiring surgery. METHODS: A prospective observational study of 2963 consecutive patients admitted to a single trauma unit with a hip fracture, treated operatively. RESULTS: The 30-day mortality for patients with low and normal urea concentrations was 6.9%. The 30-day mortality for patients with raised urea concentrations was almost double (11.5%). A raised admission serum urea concentration was an independent predictor for mortality at 30 days, 90 days, 1 year and 2 years. Mortality was significantly increased in patients admitted with: raised or low serum sodium, raised serum potassium and raised serum creatinine. CONCLUSION: Mortality is high following hip fracture. Patients admitted with a raised serum urea are at increased risk of death at all time intervals analysed up to and including 2 years. This group of patients may require a separate care pathway that provides more intensive management of fluid and electrolyte balance.