$Surreal illustration of hip fracture complications in older adults$

Hip Fracture Complications: What You Need to Know

Lena Voss in Health & Wellness November 2025 • 4 min read.

"A Comprehensive Guide to Clinical Complications and Associated Factors in Acute Geriatric Orthopaedic Care"

Hip fractures pose a significant health risk for older adults, leading to both increased mortality and substantial morbidity. While the acute mortality rate ranges from 2% to 7%, the high incidence of clinical complications significantly impacts patient outcomes. Factors such as pre-existing health conditions and the stress of surgery contribute to these complications. However, the reported incidence of these complications varies widely, ranging from 20% to 89.3%, underscoring the need for standardized approaches to prevention and management.

The implementation of Orthogeriatric Units (UOGs) has shown promise in improving outcomes for hip fracture patients. UOGs focus on reducing hospital stays, lowering mortality rates, decreasing costs, and minimizing readmissions. As such, UOGs have become the standard setting for studying hip fracture patients. Recent collaborative efforts between geriatricians and orthopedic surgeons, supported by the AOTrauma Network, have led to the development of standardized recommendations for variables and scales used in UOG research, with the goal of addressing previous methodological inconsistencies.

Building on these efforts, a new study evaluates the clinical course of older hip fracture patients admitted to the UOG at Infanta Sofía University Hospital, using the latest recommendations from the AOTrauma Network. The study identifies key factors associated with medical complications and analyzes the primary causes of mortality in these patients.

What Are the Most Common Clinical Complications After a Hip Fracture?

Surreal illustration of hip fracture complications in older adults

A recent study published in the journal Revista Española de Geriatría y Gerontología analyzed data from 383 patients admitted to an Orthogeriatric Unit (UOG) following a hip fracture. The study revealed that a significant majority, 71.3%, experienced at least one clinical complication during their hospital stay. Here’s a breakdown of the most prevalent issues:

Delirium was the most frequent complication, affecting 55.4% of patients. Delirium is a state of acute confusion characterized by changes in awareness, attention, and cognition. It can manifest as:

Difficulty focusing or paying attention
Disorganized thinking
Fluctuating levels of consciousness
Agitation, restlessness, or hallucinations

Renal failure affected 15.4% of patients, potentially leading to fluid and electrolyte imbalances and overall health deterioration. Cardiac complications occurred in 12.3% of patients and included acute coronary syndrome, atrial fibrillation, and acute heart failure. Other complications that occurred, but at lower rates, include urinary tract infections (11.5%), pulmonary complications (9.1%), digestive issues (3.3%), and neurological events (3.1%).

Prioritizing Prevention and Integrated Care

By focusing on early detection, integrated care models, and preventative strategies, healthcare professionals can mitigate the impact of hip fractures and improve the quality of life for older adults. Further research and collaboration are essential to refine these approaches and ensure the best possible outcomes for this vulnerable population.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.regg.2018.01.002, Alternate LINK

Title: Evaluación De Las Complicaciones Clínicas De Los Pacientes Con Fractura De Cadera Y Sus Factores Asociados En Una Unidad De Agudos De Ortogeriatría

Subject: Geriatrics and Gerontology

Journal: Revista Española de Geriatría y Gerontología

Publisher: Elsevier BV

Authors: Rafael Bielza, Paola Fuentes, David Blanco Díaz, Ricardo Vicente Moreno, Estefanía Arias, Marta Neira, Ana M. Birghilescu, Jorge Sanjurjo, Javier Escalera, David Sanz-Rosa, Israel J. Thuissard, Jorge F. Gómez Cerezo

Published: 2018-05-01

Everything You Need To Know

What are the most frequent clinical complications that can arise after an older adult suffers a hip fracture?

After a hip fracture, the most frequent clinical complication is Delirium, affecting 55.4% of patients. Delirium is an acute state of confusion with symptoms such as difficulty focusing, disorganized thinking, fluctuating consciousness, and agitation. Other common complications include renal failure (15.4%), which can cause electrolyte imbalances, and cardiac complications (12.3%) like acute coronary syndrome, atrial fibrillation, and acute heart failure. Urinary tract infections, pulmonary complications, digestive issues, and neurological events can also occur, though less frequently.

How do Orthogeriatric Units (UOGs) and collaborative networks like the AOTrauma Network contribute to improving outcomes for hip fracture patients?

Orthogeriatric Units (UOGs) have been shown to improve outcomes for hip fracture patients by focusing on reducing hospital stays, mortality rates, costs, and readmissions. The AOTrauma Network supports collaborative efforts between geriatricians and orthopedic surgeons to develop standardized recommendations for research within UOGs. A recent study at Infanta Sofía University Hospital evaluated the clinical course of older hip fracture patients admitted to the UOG, using AOTrauma Network's recommendations to identify factors associated with medical complications and causes of mortality.

What exactly is Delirium and what are its symptoms, especially in the context of recovery from a hip fracture?

Delirium after a hip fracture is an acute state of confusion characterized by changes in awareness, attention, and cognition. Patients may experience difficulty focusing, disorganized thinking, fluctuating levels of consciousness, and symptoms such as agitation, restlessness, or hallucinations. Recognizing and addressing Delirium is crucial due to its high prevalence (55.4% of patients in one study) and potential impact on recovery.

Beyond what's listed, what other preventative strategies and care models could minimize complications after a hip fracture?

Integrated care models and preventative strategies are crucial for mitigating the impact of hip fractures. Early detection of potential complications, combined with coordinated care between healthcare professionals, can improve outcomes for older adults. While not explicitly detailed, these strategies could include optimizing nutrition, managing pre-existing conditions, implementing mobility programs, and providing psychological support to reduce the risk of complications such as Delirium, renal failure, and cardiac issues. Further research and collaboration are essential to refine and implement these approaches effectively.

What percentage of hip fracture patients experience complications requiring hospitalization, and why is this number significant?

A recent study analyzing data from 383 patients admitted to an Orthogeriatric Unit (UOG) following a hip fracture revealed that 71.3% of patients experienced at least one clinical complication during their hospital stay. While the article mentions a few complications (Delirium, renal failure and cardiac complications) it does not cover every single possible one that a patient can acquire. This statistic underscores the importance of focusing on early detection, integrated care models, and preventative strategies to mitigate the impact of hip fractures and improve outcomes for older adults.