Injury Mechanisms of Hip Fractures in India

George, Jaiben; Vp, Sharma; Farooque, Kamran; Mittal, Samarth; Trikha, Vivek; Malhotra, Rajesh

doi:10.5371/hp.2021.33.2.62

Cited by 12 publications

(5 citation statements)

References 44 publications

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“…According to the results of our analysis, a substantial increase in mortality was observed when the delay was longer than six days and the association was more significant in medically unfit patients. While most guidelines recommend surgery within 36-48 hours, these guidelines may not apply to countries like India where substantial delays in both reaching the hospital and undergoing surgery are possible 17 20 29) . The findings of our study may be helpful in establishing guidelines in resource-limited settings where hospital resources can be optimally distributed between hip fracture patients and other patients in need of urgent surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?

George,

Sharma,

Farooque

et al. 2023

Hip & Pelvis

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Purpose Delay in performance of hip fracture surgery can be caused by medical and/or administrative reasons. Although early surgery is recommended, it is unclear what constitutes a delayed surgery and whether the impact of delayed surgery can differ depending on the reason for the delay. Materials and Methods A total of 269 consecutive hip fracture patients over 50 years of age who underwent surgery were prospectively enrolled. They were divided into two groups: early and delayed (time from reaching the hospital to surgery less than or more than 48 hours). Patients were also categorized as fit or unfit based on anesthetic fitness. One-year mortality was recorded, and regression analyses were performed to assess the impact of delay on mortality. Results A total of 153 patients (56.9%) had delayed surgery with a mean time to surgery of 87±70 hours. A total of 115 patients (42.8%) were considered medically fit to undergo surgery. No difference in one-year mortality was observed between patients with early surgery and those with delayed surgery ( P =0.854). However, when assessment of the time to surgery was performed in a continuous manner, mortality increased with prolonged time to surgery, particularly in unfit patients, and higher mortality was observed when the delay exceeded six days (fit: P =0.117; unfit: P =0.035). Conclusion The effect of delay on mortality was predominantly observed in patients who were not considered medically fit, suggesting that surgical delays might have a greater impact on patients with medical reasons for delay.

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Section: Discussionmentioning

confidence: 99%

The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?

George,

Sharma,

Farooque

et al. 2023

Hip & Pelvis

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“…Trivial trauma and fall on the ground were cause of hip fracture in 12 (10%) and 5 (4.17%) patients, respectively. George et al conducted a study to analyze injury patterns of hip fractures in India [14]. The study found that the mechanism of injury for the majority of patients was either fall from a standing height or road traffic chance.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status and Its Effect on Functional Outcome in Patients With Hip Fracture: An Observational Study

KARAN HINGANKAR,

AVINASH KEDARI,

RAJ PRAMOD GANDHI

et al. 2023

Asian J Pharm Clin Res

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Aims and Objectives: The study aimed to study the Vitamin D status of adult patients presenting with hip fractures and analyze potential impact of Vitamin D status on outcome of these patients. Methods: This was an observational study of Vitamin D status of patients presenting with hip fractures. It was conducted in the department of orthopedics of a tertiary care medical college. One hundred and twenty adult patients presenting with hip fractures were included in this study on the foundation of a predefined inclusion and exclusion criteria. Demographic details of all the patients such as age, gender, and socioeconomic status were noted. Vitamin D status of patients was determined and correlated with functional outcome at the time of final follow-up visit at 6 months. Results: Among the 120 studied with hip fractures, 64 cases (53.33%) involved females, while 56 cases (46.67%) involved males having a M: F ratio of 1:1.14. The mean age of male and female patients was found to be 45.85±10.12 and 46.74±9.86 years. Overall, 65 (54.17%) patients were Vitamin D sufficient and remaining 55 (45.83%) were either inefficient (26.67%) or deficient (19.17%). Seventy-three (60.83%) patients had excellent to good outcome whereas 31 (25.83%) patients had fair outcome. Out of remaining 16 patients, 11 (9.17%) patients had poor outcome and 5 (4.17%) patients had very poor outcome. The patients with sufficient Vitamin D status were found to have a better outcome as compared to those patients with inefficient or deficient Vitamin D status and the difference was found to be statistically significant (p=0.01). Conclusion: It is significant to treat Vitamin D deficiency in patients presenting with hip fractures as Vitamin D deficiency is associated with suboptimal functional outcome in cases with hip fractures.

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“…In addition, we also found the female took 72.16% of patients in the NS-STT group, compared to 39.04% in non-NS-STT group, that the gender was related to NS-STT changes on electrocardiogram. In the previous studies, the female related to hip fracture 36 has been identified. Thus, gender was another confounding factor.…”

Section: Discussionmentioning

confidence: 99%

Nonspecific ST-Segment and T-Wave (NS-STT) on Electrocardiogram is Associated with Increasing the Incidence of Perioperative Deep Vein Thrombosis in Patients with Lower Extremity Fracture Under 75 Years Old

Ren¹,

Li²,

Ma³

et al. 2021

IJGM

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Objective This study aims to explore the clinical correlation between nonspecific ST-segment or T-wave (NS-STT) changes and perioperative deep vein thrombosis (DVT) in patients with lower extremity fractures. Methods One thousand four hundred sixty-nine consecutive patients who suffered lower extremity fractures were screened at Xi’an Honghui Hospital between Feb 2016 and Nov 2018. According to the included and excluded criteria, the patients were included in this retrospective study. After collecting the electrocardiogram baseline, the patients were divided into the NS-STT group and the non-NS-STT group. After comparing the demographic and clinical characteristics, multivariate logistic regression models were used to identify the role of NS-STT changes on perioperative DVT. All analyses were performed with R and EmpowerStats software. Results Nine hundred and sixty-eight patients were included in the study. Ninety-seven patients (10.02%) had NS-STT changes on the electrocardiogram at admission. A total of 303 patients (31.30%) developed perioperative DVT in lower extremities. The univariate analysis showed that NS-STT segment changes were correlated with perioperative DVT significantly (OR = 3.45, 95% CI: 2.25–5.30, P < 0.0001). In addition, age ≥50 ( P < 0.0001), female (OR = 1.50, 95% CI: 1.14–1.97, P = 0.0038), hypertension (OR = 1.54, 95% CI: 1.08–2.20, P = 0.0161), blood transfusion (OR = 1.78, 95% CI: 1.34–2.37, P < 0.0001), joint prosthesis (OR = 3.26, 95% CI: 2.21–4.81, P < 0.0001), and blood loss ≥300 mL (OR = 2.12, 95% CI: 1.50–3.01, P < 0.0001) were associated with perioperative DVT in lower extremities. We identified the confounding factors of age, gender, classification of internal implants, operation time, blood loss, and infusion. After adjustment for potential confounding factors, NS-STT changes were associated with perioperative DVT (OR = 2.13, 95% CI: 1.33–3.42; P = 0.0017). The sensitive analysis showed that the result was stable. Conclusion The NS-STT changes on electrocardiograms are associated with an increase in the incidence of perioperative DVT by 2.13-fold in patients with lower extremity fractures under 75 years old. In clinical practice, surgeons should pay more attention to these patients.

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Injury Mechanisms of Hip Fractures in India

Cited by 12 publications

References 44 publications

The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?

The Impact of Surgical Timing of Hip Fracture on Mortality: Do the Cause and Duration of Delay Matter?

Vitamin D Status and Its Effect on Functional Outcome in Patients With Hip Fracture: An Observational Study

Nonspecific ST-Segment and T-Wave (NS-STT) on Electrocardiogram is Associated with Increasing the Incidence of Perioperative Deep Vein Thrombosis in Patients with Lower Extremity Fracture Under 75 Years Old

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