Outcomes of trauma in centenarians

Kent, Michael; Elliot, Robin; Taylor, Heath

doi:10.1016/j.injury.2008.10.017

Cited by 20 publications

(16 citation statements)

References 11 publications

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“…HF, one of the most frequent age-related injuries, is an important cause of hospitalization among centenarians [7,13,15]. While the inhospital mortality is between 7.7%-31%, as reported by the literature, the short-and medium-term mortality rates are particularly high in this group of extreme age [2,[5][6][7][8]13].…”

Section: Discussionmentioning

confidence: 91%

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Hip fracture in centenarians: Retrospective analysis of an orthogeriatric unit reveals the limitations of the current research

Mazzola¹,

Perego²,

Picone³

et al. 2015

Glob Anesth Perioper Med

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Life expectancy of Italian people is among the highest in the world, at 80 years for males and 85 years for females. Estimates from the National Institute of Statistics show that people aged 65 years and older represent more than 21% of the Italian population. Among them, centenarians represent the age group with the highest growing rate. Hip fracture incidence increases with advancing age, and currently represents one of the major causes of hospitalization in the elderly. Many studies regarding hip fracture in the elderly have been published, but research focusing on centenarians is still very limited despite their growing trend. This manuscript reviews the activity of the Orthogeriatric Unit at San Gerardo University Hospital (Northern Italy) from its establishment in 2007 until the present, and enlightens the limitations of the research in this area reviewing the literature currently available.Over a 7-year period, we admitted a small population of 10 centenarian female patients, all of whom underwent surgery. Their in-hospital (1 out of 10) and 1-year mortality rates (8 out of 10) are consistent with the existing literature.Centenarians pose an increasing challenge to physicians and surgeons. Rates of recovery of the pre-fracture condition are undoubtedly lower than those in younger geriatric patients, but surgery and early rehabilitation should not be denied solely due to the extreme age of these subjects. However, the research in this area presents several limitations up to now. The available studies are sparse, describe small populations, and are generally a single-center retrospective review of the local hospital admissions registry. Moreover, the objectives and outcome measurements vary considerably between studies, making a statistical comparison unfeasible.In this scenario, the implementation and analysis of large-scale databases would allow appropriate research among centenarians, including cost-effectiveness of specific surgical treatments.

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Section: Discussionmentioning

confidence: 91%

“…In 2009, a manuscript from Kent and colleagues described the results of a retrospective observational database analysis (2004)(2005) in a UK hospital in Dorset [15]. The authors focused on 26 trauma admissions in centenarians, 13 of whom were hospitalized for HF.…”

Section: Review Of the Literaturementioning

confidence: 99%

Hip fracture in centenarians: Retrospective analysis of an orthogeriatric unit reveals the limitations of the current research

Mazzola¹,

Perego²,

Picone³

et al. 2015

Glob Anesth Perioper Med

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“…The mortality was higher than the in-hospital mortality (p = < 0.001) and the 1 year mortality (p = 0.002) for proximal femur fractures at all ages. In 2004 Oliver and Burke reported on 18 centenarians with hip fractures who had an in hospital, 1 and 4 month mortality of 11.1%, 33.3% and 50% respectively [5]. In the centenarians the 4 month mortality was significantly higher than a hip fracture cohort in the 75 to 83 age range (p = 0.007).…”

Section: Introductionmentioning

confidence: 99%

“…Twenty two percent of the centenarians regained prefracture walking ability and 28% were able to continue living independently post fracture. Kent et al in 2009 presented 13 proximal femur fractures 10 of whom had surgery, the in-patient mortality was 50% and the 1 year mortality was 41 .6 % [6]. Verma et al in 2009 reported on the largest series so far with 26 centenarians who had proximal femur fractures [7].…”

Section: Introductionmentioning

confidence: 99%

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Outcome Following Surgery for Proximal FemurFractures in Centenarians

2017

American Research Journal of Orthopedics and Traumatology

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PurposeThe Heart of England Foundation Trust has a catchment area of 1.5 million and admits more than one thousand patients with a proximal femur fracture annually. In an aging population, many of these are centenarians. In England and Wales in 2012, there were 12320 centenarians. Given the poor outcomes reported in this patient group further study is important. We report one of the largest known series assessing outcomes and examining the implications for resource allocation. MethodsThirty-two centenarians with a proximal femur fracture who were admitted between January 2000 and April 2012 were compared with a group of 33 patients aged between 60-95 years. Patient outcomes were measured in terms of mortality, mobility, and post operative residential status. ResultsThe average age amongst centenarians was 101.71 years, with a female preponderance in both groups. Three quarters of younger patients lived at home compared with 40.6% aged ≥100 years. As expected, younger patients had better pre-morbid mobility, with 42.42% walking independently compared with 9.37% of centenarians. The distribution of fracture types was similar in both groups.Centenarians' stay was 10.1 days greater than younger patients, whilst in-hospital mortality was 18.8% compared with 34.4% (younger vs centenarians). Thirty day mortality was almost double in centenarians whilst 120 day mortality, at 62.5% compared with 21.2% in the younger patients was statistically significant.Upon discharge, two thirds of younger patients returned home, compared with only 15.6% of centenarians. Of the younger patients, 42.4% regained pre-fracture mobility compared with 15.6% of centenarians. None of the younger patients were unable to walk post-operatively compared with more than 33% of centenarians. ConclusionsOur findings support previous studies which show that centenarians have poor outcomes with a 120 day mortality exceeding 50%. Such patients require prolonged hospitalisation and social care support. It emphasises the requirement for preventative resource allocation to an aging population.

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