Quality of Life after Hip Fracture Surgery in the Elderly

Abstract

As the world population ages, the prevalence of osteoporosis and the incidence of hip fractures will increase dramatically, being responsible for an increase of the health expenditure. On the other hand, there is the inescapable fact of scarcity creating the necessity of making difficult choices with regard to the allocation of human resources. So the question remains: should we carry on investing an important part of our health expenditure for the treatment of hip fractures in elderly people? To answer this statement, we compared 384 hip fracture patients of 70 years and older treated in our department between 1978 and 1983 with 1102 patients treated between 1998 and 2003. Both groups had a prospective follow-up of at least one year. There were no statistically significant differences: mortality rate 24% vs. 23%; good functional outcome 82% vs. 73%; and home going rate 60% vs. 66%. The factors influencing these results were studied. So we can conclude: The number of hip fractures treated nowadays has increased compared with twenty years ago; There is no significant improvement in mortality, nor in quality of life; Age is not a contraindication for hip fracture surgery.

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

“…1 Approximately 30% of patients under the age of 80 years were unable to walk independently 1 year after hip fracture and became home-bound; 20% to 40% of patients were admitted to an elderly care home; and all patients suffered both physically and psychologically with re-fracture and fear of falls. 2 Hip fracture patients with poor functional recovery are unable to resume their prefracture function with a consequent deterioration in quality of life. Mortality at 1 year after hip fracture was as high as 27% in males and 15% in females.…”

Analysis of Mortality in Patients With a Fracture of the Proximal Femur

“…Через 1 год после перелома летальность, по данным ли-тературы, варьирует в очень широком диапазоне от 14,85 до 48,5%, хотя в большинстве работ показатель составляет 21 -34% [10, 15,16,17,18,19,20,21,22,23,24,34]. В про-веденном исследовании летальность через год составила 29,82%, то есть была сопоставима.…”

“…В про-веденном исследовании летальность через год составила 29,82%, то есть была сопоставима. Хотя при этом следу-ет отметить, что во многих работах приводятся данные по показателю летальности только среди прооперированных пациентов, что, в свою очередь, составляет от 21,2 до 30% [17,15,16,19,20]. В г. Ярославле через 1 год наблюдения изучаемый показатель оказался равным 24,76%.…”

“…По данным разных авто-ров [8, 9, 10,11,12], летальность в стационаре среди па-циентов пожилого и старческого возраста с ППОБ состав-ляет от 4,31% до 6,3%; через 4 месяца после травмы -от 15,9% до 20% [13,14]; через 1 год после перелома -14,85 -48,5% [10,15, 16,17,18, 19, 20,21,22,23, 24]; через 2 года данный показатель уже составляет от 36,2 до 39,0% [9,18].…”

Avaliação da taxa de mortalidade em um ano após fratura do quadril e fatores relacionados à diminuição de sobrevida no idoso

“…Thus, elderly people are much more subject to complications, both during the immediate postoperative period and later on (8) . Studies in developed countries have suggested that certain preoperative factors are associated with higher mortality rates among patients presenting hip fractures on admission, for example: nonwhite color (3,(9)(10)(11)(12) , advanced age (11,(13)(14)(15) , presence of dementia (16)(17)(18) , male sex (13,19,20) , clinical comorbidities (11,14,16,21,22) and delirium (18,23,24) . In view of the importance that fractures of the proximal femur have for society, our aim was to determine the mortality rate and preoperative factors related …”