Comorbidities, clinical intercurrences, and factors associated with mortality in elderly patients admitted for a hip fracture

Abstract

ObjectiveTo analyze comorbidities and clinical complications, and to determine the factors associated with mortality rates of elderly patients admitted with a hip fracture in a tertiary public hospital.MethodsSixty-seven medical records were reviewed in a retrospective cohort study, including patients equal to or older than 65 years admitted to this institution for hip fracture between January 2014 and December 2014. The evaluated items constituted were the following: interval of time between fracture and hospital admission, time between admission and surgical procedure, comorbidities, clinical complications, type of orthopedic procedure, surgical risk, cardiac risk, and patient outcome.ResultsThe average patients’ age in the sample was 77.6 years, with a predominance of the female gender. Most patients (50.7%) had two or more comorbidities. The main clinical complications during hospitalization included cognitive behavioral disorders, respiratory infection and of the urinary tract. The times between fracture and admission and between admission and surgery were more than seven days in most of cases. The mortality rate during hospitalization was 11.9%, and was directly connected to the presence of infections during hospital stay (p = 0.006), to time between admission and surgery longer than seven days (p = 0.005), to the Goldman Cardiac Risk Index class III (p = 0.008), and to age equal to or greater than 85 years (p = 0.031).ConclusionPatients with hip fractures generally present comorbidities, are susceptible to clinical complications, and have an 11.9% mortality rate.

Mortality and Medical Complications of Subtrochanteric Fracture Fixation

“…Dementia in particular, was found to be an independent predictor of mortality in our cohort, confirming previously reported findings [ 12 , 16 , 17 ]. Additionally, the presence of pneumonia significantly increased mortality, which was again in line with previous findings [ 18 , 19 ].…”

Investigating the potential underdiagnosis of primary hyperparathyroidism at the University of Arkansas for Medical Sciences

“…In a study of nearly 100 000 Medicare patients with vertebral fracture by Lau et al, 7‐year risk of death was nearly doubled in an elderly person with vertebral fracture when compared to elderly counterparts without fracture, after adjustment for comorbidity 12 . Regarding hip fractures, a recent study by Edelmuth et al demonstrated a mortality rate of 11.9% during hospitalization for elderly patients admitted after surgery for hip fracture 13 …”

Identificação dos diagnósticos de enfermagem em recuperação pós-anestésica segundo a Teoria das necessidades humanas básicas

“…As comorbidades clínicas constituem um importante fator de risco para maior mortalidade, além de estarem associadas ao surgimento de complicações pós-cirúrgicas, que podem ser imediatas ou tardias. A avaliação pré-operatória, portanto, deve estar baseada em exame criterioso de toda história clínica do paciente, de modo a estabelecer medidas de prevenção de eventos mórbidos, evitar iatrogenias, definir critérios que alertem para um maior risco e desenvolver enfoque multidisciplinar (Edelmuth, Sorio, Sprovieri, Gali, & Peron, 2018).…”