Bone Abstracts

Introduction: Pelvic fragility fractures are common but frequently under-recognised in older adults. This study aimed to compare the 30-day and 90-day mortality after pelvis and hip/femoral fracture within the Gwent population (592,000).

Methods: A retrospective service evaluation was undertaken of all fragility fracture patients reviewed by the Aneurin Bevan Fracture Liaison Service (AB-FLS) from January 2022 to December 2025.

Results: Case detection improved substantially following enhanced radiology collaboration and systematic screening of radiology reports: 56 cases were identified in 2022, rising to 97 in 2023, 220 in 2024, and 217 in 2025. The average annual incidence was 36.9 per 100,000 in 20242025 with improved ascertainment. A total of 9,832 patients were assessed (mean age 78.9±9.8 years), of whom 75.5% were female (n7,420). Mean age was 78.8±10.0 years in females and 79.3±9.1 years in males, P 0.02). Analysis of 590 pelvic fractures and 2992 hip/femur fractures (20222025) were completed. Over half of pelvis fracture patients (58% n342/590) had at least one prior fragility fracture. 62.3% pelvic fracture (n368/590) required hospital admission. Mean age for pelvis and hip/femur fractures were 83.7±8.3 years and 82.5±8.8, (P 0.002) respectively. Females accounted for 78.6% of pelvic fractures and 69.6% of hip fractures (P 0.0001). 30-day and 90-day mortality following pelvic fracture were 4.2% (25/590) and 9.3% (55/590), respectively. In comparison, mortality following hip or femoral fracture was 5.3% (159/2992) at 30 days and 9.9% (295/2992) at 90 days, difference in proportion test for 30-day mortality P 0.27; 90-day mortality, P 0.65. Mean hospital stay was 32± 37days for pelvic fractures (n371) and 31±48 days for hip fractures (n2,196, P 0.64). Conclusion Pelvic fractures are associated with a substantial 30-day and 90-day mortality rates comparable to those observed following hip/femoral fractures, with no statistically significant difference in mortality between the two cohorts at either time point. These findings underscore the need for strengthened, multidisciplinary care pathways involving Radiology, Orthogeriatrics, Rheumatology, and FLS. Such integrated approaches are essential to facilitate timely diagnosis, optimise bone health management, and coordinated follow-up care for pelvic fractures patients similar to hip fractures.