Patients with hip fracture admitted to critical care: Epidemiology, interventions and outcome

Gibson, Alistair A.; Hay, Ashley; Ray, David C.

doi:10.1016/j.injury.2014.02.037

Cited by 19 publications

(13 citation statements)

References 18 publications

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“… 10 , 13 , 14 , 16 , 24 Sepsis was significantly associated with the death group ( p = 0.001). In a study published in 2014, Gibson et al 30 demonstrated that one-third of patients with proximal femoral fracture admitted to the intensive care unit with sepsis died in the unit and another one-third died outside the unit before discharge.…”

Section: Discussionmentioning

confidence: 99%

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil

Guerra

Viana

Feil

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution.MethodThe authors reviewed 213 medical records of hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013.ResultsOne-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio. Anemia (p = 0.000) and dementia (p = 0.041) were significantly associated with the death group. Patients who remained hospitalized for less than 15 days and who were discharged within seven days after surgery showed increased survival.ConclusionIn the present sample of patients with hip fracture who underwent surgery, one-year mortality rate was 23.6%, and the main comorbidities associated with this outcome were anemia and dementia.

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Section: Discussionmentioning

confidence: 99%

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil

Guerra

Viana

Feil

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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“…demonstrated decreased length of stay (LOS) at the post-anaesthesia care unit (PACU) and decreased in-hospital mortality when implementing a clinical pathway in PACU 21 . The effects of PACU-LOS and ICU-admission after hip fracture surgery have been sparingly investigated 22 , 23 .…”

Section: Introductionmentioning

confidence: 99%

Determinants of mortality after hip fracture surgery in Sweden: a registry-based retrospective cohort study

Åhman

Siverhall

Snygg

et al. 2018

Sci Rep

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Surgery for hip fractures is associated with high mortality and morbidity. The causes of poor outcome are not fully understood and may be related to other factors than the surgery itself. The relative contributions of patient, surgical, anaesthetic and structural factors have seldom been studied together. This study, a retrospective registry-based cohort study of 14 932 patients undergoing hip fracture surgery in Sweden from 1st of January 2014 to 31st of December 2016, aimed to identify important predictors of mortality post-surgery. The independent predictive power of our included variables was examined using Cox proportional hazards modeling with all-cause mortality at longest follow-up as the outcome. Twelve independent variables were considered as interrelated ‘exposures’ and their individual adjusted effect within a single model were evaluated. Kaplan-Meier curves were also generated. Crude mortality rates were 8.2% at 30 days (95% CI 7.7–8.6%) and 23.6% at 365 days (95% CI 22.9–24.2%). Of the 12 factors entered into the Cox regression analysis, age (aHR1.06, p < 0.001), male gender (aHR 1.45, p < 0.001), ASA-PS-class (ASA 1&2 reference; ASA 3 aHR 2.12; ASA 4 aHR 4.79; ASA 5 aHR 12.57 respectively, p < 0.001) and PACU-LOS (aHR 1.01, p < 0.001) were significantly associated with mortality at longest follow-up (up to 3 years). University hospital status was protective (aHR 0.83, p < 0.001) in the same model. Age, gender and ASA-PS-class were strong predictors of mortality after surgery for hip fractures in Sweden. University hospital status and length of stay in the postoperative care unit were also identified as modifiable risk factors after multivariable adjustment and require confirmation in future studies.

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“…Hungria et al 13 , Gibson and Hay 14 and Boulton et al 15 argue that the proximal fracture of the femur affects older elderly people, as the musculoskeletal alterations that compromise the performance of motor skills make it difficult for such individuals to adapt to the environment and predispose them to falls from their own height.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of a care program for elderly patients with hip fractures: a network strategy

Farias

Terra

Guerra

2017

Rev. bras. geriatr. gerontol.

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Objective: Evaluate the effectiveness of a care program for elderly persons with hip fractures due to a fall, based on a public network in Canoas, Rio Grande do Sul, Brazil. Methods: a prospective cohort study of quantitative character was carried out. A total of 182 elderly person above 60 years diagnosed with hip fractures were included. The sample was divided into two groups, one who underwent their usual treatment (n=91) and another who were included in a care program for elderly persons with hip fractures (n=91). The program had as its main axis a clinical Protocol and an Access Protocol. The treatment of choice was surgical in all cases. In statistical analysis, categorical variables were described by absolute and relative frequencies. The Mann-Whitney test was used to compare numeric variables. In the comparison of proportions, the Pearson's Chi-squared test or Fisher's exact test were applied. The significance level adopted was 5%. Results: The average age was 79.4 years, with a prevalence of the female gender. The most frequent morbidity was hypertension. After the implementation of the program there was a reduction in the average time between the fracture and the beginning of surgery, the average length of hospitalization, the urinary tract infection rate, the death rate and care costs. Conclusion: The care program of elderly persons with hip fractures modified the expected results as it reduced mortality, average hospital stay, postoperative complications and the costs of treatment during the hospitalization.

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Patients with hip fracture admitted to critical care: Epidemiology, interventions and outcome

Cited by 19 publications

References 18 publications

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil

Determinants of mortality after hip fracture surgery in Sweden: a registry-based retrospective cohort study

Evaluation of the effectiveness of a care program for elderly patients with hip fractures: a network strategy

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