Postoperative Mortality and the Associated Factors in Elderly Patients with Hip Fracture

Abstract

Purpose: The aim of this study was to determine the mortality and factors that are related to the mortality in elderly patients with hip fracture. Materials and Methods: Between March 2006 and December 2009, 304 patients who were 65 years or older underwent surgery for hip fracture. Among them, 261 patients were available and 43 patients excluded from this study, as they were unable to be evaluated for one year mortality. We analyzed the relationship between the postoperative mortality and the associated factors (age, gender, the type of operation, the type of fracture, method of anesthesia, comorbidity, operation delay). Results: The one year mortality rate for elderly patients with hip fracture was 10.7%. There was no relationships between the postoperative mortality and the type of operation, the type of fracture, and method of anesthesia. However, age, gender, the number of comorbidity, operation delay, and dementia of comorbidity were factors associated with the mortality rate for elderly patients with hip fracture. Conclusion: The one year mortality rate for elderly patients with hip fracture was 10.7%. Age, gender, the number of comorbidity, operation delay, and dementia of comorbidity were factors associated with the mortality rate in elderly patients with hip fracture.

Survivorship and Complications after Hip Fracture Surgery in Patients with Chronic Kidney Disease

“…Based on a number of previous studies, 1-year mortality after hip joint surgery is reported to be 10.7%–36% ( 1 2 3 ). In particular, 1-year mortality is reported to be very high in patients with CKD, at 50%–64% ( 4 5 6 7 ).…”

“…In the present study, the 1-year mortality after hip joint surgery in patients with CKD was 32.4%, which was relatively lower than that reported in other studies, but was still high compared to the healthy patient group (13.7%). Generally, a patient's condition before surgery is known to have a large effect on mortality after hip fracture surgery ( 1 3 11 ). Roche et al ( 11 ) performed a large-scale prospective study in 2,448 patients and reported that underlying diseases prior to surgery that affect postoperative 1-year mortality include lung disease (HR, 1.4), renal disease (HR, 1.6), diabetes (HR, 1.3), and cancer (HR, 1.6), with risk reported to be high for renal disease and cancer.…”

“…The present study also found that the stage of CKD (stages 4 or 5), cancer, and cerebrovascular disease were important factors in mortality after hip fracture surgery. Several researchers have also reported that age is an important factor influencing mortality after hip fracture surgery ( 1 3 11 ). In particular, Suh et al ( 3 ) reported that mortality was significantly higher in patients ≥ 85 years old compared to that in patients < 85 ( P = 0.006), and Roche et al ( 11 ) found 2-fold higher risk of mortality in patients aged 80–89 years compared to patients aged 60–69 years, as well as 2.8-fold higher risk in patients aged ≥ 90 years old.…”

“…In terms of preoperative underlying diseases, diabetes, hypertension, cardiac disease (ischemic heart diseases, congestive heart failure, and cardiomyopathy), cancer (breast cancer, stomach cancer, colon cancer, rectal cancer, and bladder cancer), cerebrovascular disease, lung disease (asthma, chronic obstructive pulmonary disease), liver disease (liver cirrhosis), dementia, and thyroid disease (hypothyroidism, hyperthyroidism) were investigated, and risk was analyzed for each of these diseases. Time from injury to surgery was analyzed by dividing the group into those who received surgery within 2 days, and those who received surgery after 3 days or more ( 1 3 9 ). Surgery time was analyzed by dividing the subjects into those whose surgery took longer than average and those whose surgery took less time than average, where the mean surgery time was calculated across the patient and control groups together.…”

“…Recently, due to the increase in the aging population, quality of life and survival after fractures in elderly patients have become important topics of social interest. Hip fractures in elderly patients have been reported to result in a 1-year mortality of 15%–40% ( 1 2 3 ), due to medical and orthopedic complications and aggravation of their comorbidity. In particular, patients with chronic kidney disease (CKD) have a very high 1-year mortality of 50%–64% after hip fractures ( 4 5 6 7 ).…”