Association Between Depression and Increased Odds of Inpatient Mortality Following Hip Fracture Repair.

Depression was present in 15.8% of older adults who underwent surgical hip fracture repair between 2016 and 2021.

• A total of 307,377 patients aged 65 years and older were identified as having a hip fracture surgically repaired from 2016 to 2021.
• Of those, 48,556 (15.8%) were depressed.
• Data were sourced from the National Inpatient Sample queried from 2016 to 2021.
• Patients with depression were more likely to be female (76.3% vs 68.6%, P < 0.01) and White (90.5% vs 86.1%, P < 0.01).

Patients with depression had significantly increased odds of inpatient mortality following hip fracture repair compared to those without depression.

• On multivariable regression analysis, patients with depression were more likely to experience inpatient mortality (OR: 1.13 to 1.33, P < 0.01).
• Analysis controlled for demographic variables and comorbidities.
• Both univariate and multivariable regression models were used to compare outcomes.

Depression was associated with increased odds of deep vein thrombosis or pulmonary embolism (DVT/PE) following hip fracture surgery.

• On multivariable regression analysis, patients with depression had higher odds of DVT/PE (OR: 1.03 to 1.23, P = 0.01).
• DVT/PE was a prespecified secondary outcome.
• Analysis accounted for demographic variables and comorbidities.

Depression was associated with increased odds of myocardial infarction following hip fracture surgery.

• On multivariable regression analysis, patients with depression had higher odds of myocardial infarction (OR: 1.02 to 1.19, P = 0.02).
• Myocardial infarction was a prespecified secondary outcome.
• Analysis accounted for demographic variables and comorbidities.

Patients with depression were less likely to experience a routine discharge following hip fracture repair.

• On multivariable regression analysis, patients with depression had lower odds of routine discharge (OR: 0.62 to 0.66, P < 0.01).
• Discharge disposition was a prespecified secondary outcome.
• The authors note this suggests depressed patients 'may face a more difficult recovery process after surgery.'

Patients with depression had a significantly longer length of stay and greater total charges following hip fracture surgery.

• Length of stay was longer in depressed patients (β coefficient 95% CI: 0.46 to 0.54, P < 0.01).
• Total charges were greater in depressed patients (β coefficient 95% CI: 2,511 to 3,716, P < 0.01).
• Both length of stay and total charges were prespecified secondary outcomes.
• Results were derived from multivariable regression analysis controlling for demographic variables and comorbidities.