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It provides evidence on the prognostic impact of comorbidity and in-hospital complications and highlights the need for specific interventions to improve care in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This work aims to describe the clinical characteristics, in-hospital progress, and risk factors for worse in-hospital outcomes in centenarian patients with proximal hip fracture (PHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective nationwide cohort study was conducted that included all centenarian patients hospitalized for PHF (2004\u20132020) according to the Spanish National Health System\u2019s Minimum Basic Data Set. Demographic, clinical, and hospitalization-related variables were analyzed. Univariate and multivariate analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 4261 patients (83.3% women). The mean Charlson comorbidity index (CCI) was 0.9\u2009\u00b1\u20091.2; 11.4% had severe comorbidity. Surgery was performed in 87.2% of patients and in 44.5% after 48\u00a0h of admission. Higher CCI scores (OR 1.3, 95% CI 1.0\u20131.7) and admission to medical departments (OR 4.11, 95% CI 3.0\u20135.6) were associated with nonsurgical management. Surgical delays\u2009\u2265\u200948\u00a0h were associated with admissions on Saturdays (OR 1.9, 95% CI 1.3\u20132.8) or to medical departments (OR 2.79, 95% CI 1.34\u20135.83) and with the development of\u2009\u2265\u20093 complications (OR 1.5, 95% CI 1.1\u20132.0). Overall, 15% of patients died during hospitalization, with significantly higher mortality in nonsurgical patients (31.8% vs. 12.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In surgical patients, mortality and prolonged hospital stays were primarily related to higher CCI scores and complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Centenarians with PHF have a low severe disease burden but high in-hospital mortality risk. Key predictors of mortality in surgical patients include higher CCI scores and in-hospital complications. This highlights the relevance of integrated care and early optimization of clinical status. Prospective studies with long-term follow-up are needed to better characterize prognostic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11657-025-01576-7","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T20:38:49Z","timestamp":1752266329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comorbidity burden, management, and in-hospital outcomes in centenarians with proximal hip fracture: a nationwide cohort study (2004\u20132020)"],"prefix":"10.1007","volume":"20","author":[{"given":"Juan Carlos","family":"Pi\u00f1eiro-Fern\u00e1ndez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n","family":"Rabu\u00f1al-Rey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Romay-Lema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rubal-Bran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Pedrosa-Fraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Mar\u00eda","family":"Santos-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoana","family":"Besteiro-Balado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roi","family":"Su\u00e1rez-Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"P\u00e9rtega-D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"issue":"8","key":"1576_CR1","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1002\/jbmr.4821","volume":"38","author":"CW Sing","year":"2023","unstructured":"Sing CW, Lin TC, Bartholomew S, Bell JS, Bennett C, Beyene K, Bosco-Levy P, Bradbury BD, Chan AHY, Chandran M, Cooper C, de Ridder M, Doyon CY, Droz-Perroteau C, Ganesan G, Hartikainen S, Ilomaki J, Jeong HE, Kiel DP, Kubota K, Wong ICK (2023) Global epidemiology of hip fractures: secular trends in incidence rate, post-fracture treatment, and all-cause mortality. 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