Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

Talsnes, Ove; Vinje, Tarjei; Gjertsen, Jan Erik; Dahl, Ola E.; Engesæter, Lars B.; Baste, Valborg; Pripp, Are Hugo; Reikerås, Olav

doi:10.1007/s00264-013-1851-3

Cited by 77 publications

(75 citation statements)

References 35 publications

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“…In addition, the in-hospital mortality rate was comparable between the cognitively impaired and the healthy patients (complication grade V according to Clavien-Dindo). Thus, the current results contrast with those of Talsnes et al [42], who reported data from the Norwegian Hip Fracture Register including the perioperative clinical courses of more than 11,000 patients. Using a multivariate analysis, these authors showed a significant effect of cognitive impairment on patients' mortality rate during in-hospital treatment.…”

Section: Discussioncontrasting

confidence: 99%

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Bliemel

Lechler

Oberkircher

et al. 2015

Dement Geriatr Cogn Disord

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Objective: To examine the influence of cognitive impairment on the functional outcomes and complication rates of patients with hip fracture during in-patient treatment. Methods: A total of 402 patients who were surgically treated for hip fractures were consecutively enrolled at a single trauma center. The patients were grouped according to their results on the Mini-Mental State Examination (MMSE), i.e., ≥20 points (group I) and ≤19 points (group II). Complication and in-hospital mortality rates as well as postoperative functional outcomes according to the Barthel Index (BI) were compared between the groups. A multivariate regression analysis was performed to control for additional factors. Results: 33% of the patients had MMSE scores ≤19 points. The complication rates were similar between the groups (p > 0.05). Likewise, the overall in-hospital mortality rates were similar between the patients in group I (4.5%) and those in group II (9.8%; β = 0.218, p < 0.740). Functional outcomes, as assessed by the BI, were lower in group II (β = -0.266, p < 0.001). The patients in group II were transferred to a rehabilitation clinic less frequently (52.3 vs. 76.0%, p < 0.001). Conclusions: Patients with lower MMSE scores are at a higher risk for poorer functional outcomes. Perioperative care should focus on the preservation of functional abilities to protect these patients from an additional loss of independence and disadvantageous clinical course.

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Section: Discussioncontrasting

confidence: 99%

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Bliemel

Lechler

Oberkircher

et al. 2015

Dement Geriatr Cogn Disord

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“…MI and cardiac AF atrial fibrillation, COPD chronic obstructive pulmonary disease *Significant a Cardiac disease included a previous history of ischaemic heart disease, myocardial injury, congestive heart failure and atrial fibrillation b Neurological disorders included a previous history of stroke, transient ischaemic attacks, Parkinson's disease or neuromuscular disease <0.001* Postoperative Hb in g/dl, mean ± SD 9.4±1. 9 9.9±1.9 0.07…”

Section: Discussionmentioning

confidence: 99%

“…One-year mortality is estimated to be between 22 % and 33 % [5,6]. Researchers aimed to predict the risk of death in HFS patients and suggest that the excess mortality is due to a combination of direct consequences of the hip fracture and the effect of pre-existing medical conditions [1,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Predictors of early mortality after hip fracture surgery

Khan

Hossain

Idbaïh

et al. 2013

International Orthopaedics (SICOT)

127

126

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Purpose The aim of this study was to examine causes and potential risk factors for 30-day mortality after hip fracture surgery (HFS) at a high-volume tertiary-care hospital. Methods We retrospectively reviewed 467 patients who underwent HFS at our institution. Multivariate analysis was undertaken to identify potential predictors of early mortality. Results The 30-day mortality rate was 7.5 % (35/467). The most common causes of death were pneumonia (37.1 %, 13/ 35), acute coronary syndrome (31.4 %, 11/35) and sepsis (14.3 %, 5/35). Surgery after 48 hours of admission had a significantly higher 30-day mortality rate (11 % versus 4 %, p =0.006). There was a significant difference in age (p =0.034), admission source (p <0.001), preoperative haemoglobin (p < 0.001), walking ability (p =0.004), number of comorbidities (p =0.004) and pre-existing dementia (p =0.01), cardiac disease (p <0.001), chronic obstructive pulmonary disorder (COPD) (p =0.036) and renal failure (p =0.007) between the 30-day mortality group and the rest of the cohort. Surgical delay greater than 48 hours, admission source and preexisting cardiac disease were identified as the strongest predictors of 30-day mortality. Conclusion Surgical delay is an important but avoidable determinant of early mortality after HFS. Respiratory and cardiac function needs to be optimised postoperatively with early intervention in patients with signs of cardiovascular compromise or infection.

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“…Deaths from cemented prostheses are higher than for uncemented prostheses at 24 hours according to a study based on the National Hip Fracture Database,7 echoing the findings from the Anaesthetic Sprint Audit of Practice 8. A study from Sweden quotes the incidence of BCIS for cemented hemiarthroplasty as high as 28%, and one from Norway of grade 3 BCIS of up to 1.7% 9 10…”

Section: Introductionmentioning

confidence: 87%

Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture

Baig¹,

Callaghan

Murphy

2017

BMJ Case Reports

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Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson proposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery". Other features include increased vascular resistance, cardiac arrhythmias and cardiac arrest post cement use.We describe a case of a patient who suffered a catastrophic reaction to cement during surgery for a comminuted proximal femoral fracture.

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Perioperative mortality in hip fracture patients treated with cemented and uncemented hemiprosthesis: a register study of 11,210 patients

Cited by 77 publications

References 35 publications

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Predictors of early mortality after hip fracture surgery

Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture

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