Preoperative predictors for mortality following hip fracture surgery: A systematic review and meta-analysis

Hu, Fangke; Jiang, Cheng‐Ying; Shen, Jing; Tang, Peifu; Wang, Yan-Fu

doi:10.1016/j.injury.2011.05.017

Cited by 532 publications

(475 citation statements)

References 83 publications

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“…However, patients in the HA group were significantly older, had more severe comorbidities reflected by ASA-Scores and presented with cognitive impairment more frequently. These factors are associated with a higher mortality after hip fracture [4] . Moreover, some laboratory parameters differed considerably between groups.…”

Section: Discussionmentioning

confidence: 99%

“…This disregards a major percentage of geriatric trauma patients. Moreover, cognitive impairment which was demonstrated to be a risk factor for higher mortality in hip fracture patients [4,31] was ignored. Similarly, other RCTs [10,11,32] and non-randomised studies did not respect patients who were confused or had neurologic impairment [17,18] as well as patients incapable of independent walking or who were bed-ridden [9,10] .…”

Section: Discussionmentioning

confidence: 99%

“…impairment or level of activity were shown to be associated with an increased mortality risk in these patients [3,4] . Moreover, several laboratory parameters such as haemoglobin, albumin, creatinine, c-reactive protein (CRP) and 25-hydroxyvitamin D (25(OH)D) were found to be associated with an increased mortality after hip fracture [5][6][7] .…”

Section: Influence Of Internal Fixation and Cemented Hemiarthroplastymentioning

confidence: 94%

“…For instance, several RCTs exclude patients with cognitive impairment [10,11] which on the other side comprise up to 30% of elderly patients with hip fracture [8,13] . Cognitive impairment was identified as a risk factor for mortality in these patients [4,13] . Furthermore, potentially important confounders as timing of surgery are not respected in recent RCTs [8][9][10][11] , although it was shown that a delay in surgery is associated with increased morbidity [14] and mortality [15] .…”

Section: Influence Of Internal Fixation and Cemented Hemiarthroplastymentioning

confidence: 97%

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Influence of Internal Fixation and Cemented Hemiarthroplasty on 1-Year Mortality in Geriatric Hip Fracture Patients

Fakler

Gräfe

Dercks

et al. 2017

International Journal of Orthopaedics

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AIM:Results after cemented Hemiarthoplasty (HA) in elderly patients with a femoral neck fracture improved over the last 20 years. We conducted this study in order to evaluate the influence of modern cemented HA compared to IF with a sliding hip screw (SHS) with regard to one year mortality. PATIENTS AND METHODS: 183 patients with a low-energy medial femoral neck fracture (AO/OTA 31-B) either treated with a SHS (n = 67) or cemented HA (n = 116) were included. Follow-up was performed at 6 and 12 months. A multivariate Cox regression analysis including nine confounding variables (age, ASA score, body mass index (BMI), cognitive function, time from admission to surgery, creatinine, c-reactive protein (CRP), 25-hydroxyvitamin D (25(OH)D) was performed. RESULTS: Patients in the HA group were significantly older (p < 0.001) and had more severe comorbidities according to the ASAScore (p = 0.017). The time interval from admission to surgery (skin incision) was beyond 48h in 6.0% of SHS patients and 17.2% in HA patients (p < 0.001). Despite of detrimental prerequisites for cemented HA, mortality rates at 1 year for HA (23.3%) showed no significant difference (p = 0.58) to IF (19.4%). After correcting for confounding variables mortality risk at one year was significantly higher in patients treated with a SHS (HR = 2.5, 95%CI 1.1-5.7; p = 0.027). CONCLUSION: We conclude that elderly patients with a femoral neck fracture might benefit from cemented HA compared to IF with a SHS in terms of 1-year mortality. New randomised controlled trials considering modern cementing techniques are needed to validate these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Influence Of Internal Fixation and Cemented Hemiarthroplastymentioning

confidence: 94%

Section: Influence Of Internal Fixation and Cemented Hemiarthroplastymentioning

confidence: 97%

See 2 more Smart Citations

Influence of Internal Fixation and Cemented Hemiarthroplasty on 1-Year Mortality in Geriatric Hip Fracture Patients

Fakler

Gräfe

Dercks

et al. 2017

International Journal of Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Therefore, several scoring methods have been created taking comorbid factors into consideration, which would be of benefit in the prediction of mortality. The Charlson Comorbidity Index (CCI) and the American Society of Anaesthesiologists score (ASA) have been widely used in the prediction of mortality 1,7,[9][10][11] . Although many scoring systems have been described in the literature, the perfect risk model for predicting mortality following hip fracture surgery does not exist, and research on the subject is ongoing 12 .…”

Section: öZmentioning

confidence: 99%