Impact of Medical and Social Determinants of Health on Survival Following Fall-Induced Hip Fractures: A Retrospective Analysis

Purpose Hip fractures are more than isolated injuries; they can lead to long-term disability, complications, and reduced survival. Managing these outcomes may depend on both medical and socioeconomic factors. This study examines the association of social determinants of health (SDOH) and key medical indicators with survival rates and postoperative hospital length of stay (LOS) in patients with hip fractures. Materials and Methods A retrospective study included patients aged ≥ 60 years with a history of fall-induced hip fracture. The collected variables included demographics, Charlson Comorbidity Index (CCI), fracture type, frequency and mechanism of falls, Fracture Risk Assessment Tool (FRAX), LOS, first-year readmissions, Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and insurance type. Cox proportional hazard models were used to evaluate mid- (1 and 3 years) and long-term (5 years) survival rates. Results We included 409 patients (81.99 ± 8.31 years; 68.9% female). Reduced 1-year survival was associated with prolonged LOS and a CCI > 6. At 3 years, age, sex, and CCI, and at 5 years, only a CCI > 6 predicted decreased survival. Conclusion This study highlights the role of age, sex, LOS, and CCI as key predictors of hip‑fracture survival, while SDOH did not show an effect. These findings underscore the need for a larger study to capture risk factors in diverse patient populations for better long-term prediction.