Risk Factors Influencing Mortality After Bipolar Hemiarthroplasty in the Treatment of Fracture of the Femoral Neck

Hip fractures have long been considered a major threat to the survival of elderly people. Most of the studies on survival following hip fractures have been reported from developed countries where orthopedic care is well distributed. This report describes the survival experience of 330 elderly hip fracture patients who were seen at hospitals in Chiang Mai, Thailand. The mortality rate during hospitalization was 2.1%. The 3-, 6-, and 12-month survival rates after hip fractures were 91%, 88% and 83%, respectively. The significant predictors of mortality were male sex, age over 80 years, presence of chronic illnesses, poor pre-fracture walking ability, and nonoperative treatment.Résumé Les fractures de la hanche ont été considérées longtemps comme une menace majeure à la survie des gens âgés. La plupart des études de survie après ces fractures ont été rapportées dans les pays développés ou existe une bonne qualité de soins orthopédiques. Ce rapport décrit l'étude de la survie de 330 patients âgés avec une fracture de la hanche qui ont été vus à l'hopital de Chiang Mai, Tha. Le taux de la mortalité pendant l'hospitalisation était 2.1%. Le taux de survie à 3, 6, et 12 mois après la fracture de la hanche était 91%, 88% et 83%, respectivement. Les éléments significativement prédictifs de la mortalité étaient : le sexe masculin, l'âge de plus de 80 ans, l'existence de maladies chroniques, la mauvaise capacité de marche avant la fracture, et un traitement non-opératoire.

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“…This finding was also demonstrated in previous studies [3,6,10]. Pre-fracture walking ability was revealed as another significant predictor.…”

Section: Discussionsupporting

confidence: 89%

Mortality after hip fractures in Thailand

Chariyalertsak

Suriyawongpisal

Thakkinstain

2001

International Orthopaedics (SICOT)

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“…27 Previous studies have identified a number of risk factors that influence mortality, including having more than 3 comorbidities, previous myocardial infarction, institutionalized patients with chronic lung disease, pneumonia, duration of surgery, sex, and serum creatinine levels greater than 1.7 mg/dL. 28 However, there are conflicting data on the relationship of renal function (assessed either by creatinine level, urea, BUN, or sodium and potassium) and mortality in this scenario. It seems that depending on the study design and population studied, any of these variables can be significantly associated with postoperative mortality.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Indirect Markers of Renal Function in Elderly Patients With Hip Fracture

López-Martínez

Tovar-Rivera

Becerra-Laparra

et al. 2014

Geriatr Orthop Surg Rehabil

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Introduction: There are risk factors associated with mortality in patients older than 70 years with hip fracture, including kidney function. However, indirect formulas to calculate glomerular filtration rate are not validated in patients older than 70 years. We analyzed whether the formula hematocrit, urea, and gender (HUGE) can be used as a prognostic factor. Material and Methods: A retrospective cohort study of 88 patients older than 70 years with a diagnosis of hip fracture. At admission, clinical and biochemical parameters were measured and glomerular filtration rate by Cockcroft-Gault, Modification Of Diet In Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and HUGE value. Accuracy to assess long-term mortality was analyzed with receiver-operating curve analysis. Cox regression analysis was performed to identify risk factor for mortality. Results: Sample included 88 patients; overall mortality was 13.63%, 17.85%, 28.57%, and 75.85% at 6 months, 1, 2, and 3 years, respectively. There was no significant difference in glomerular filtration rate by different formulas, contrary to HUGE, with higher values in the mortality group (1.83 + 6.38 vs À2.61 + 2.70, P ¼ .0001). Survival was lower in patients with higher HUGE values (22.7 months, 95% confidence interval [CI] 16.1-29.5 vs 32.9 months, 95% CI 30.2-35.7; P .001). In the Cox regression analysis, a negative HUGE value is associated with lower mortality (hazards ratio ¼ 0.238; 95% CI 0.568-0.099). Conclusion: The HUGE formula is an independent risk factor for mortality in elderly patients with hip fracture, but not the glomerular filtration rate determined by Cockcroft-Gault, MDRD, and CKD-EPI.

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“…Haidukewych et al [13] reported high component survivorship (95.1% at 5 years, 93.6% at 10 years, and 89.2% at 15 years) and a low dislocation rate (1.9%) after bipolar HA for displaced femoral neck fractures in elderly patients. However, high death rates (14%-47% [9,11,31]) and postoperative complication rates (32%-87% [11,31]) have been reported after surgically treating patients who had neuromuscular disease, particularly after the treatment of fractures about the hip [3,9,10,12]. Some studies suggest these patients have high rates of dislocation ranging from 10.6% to 45% [9,25,31], and decubitus ulcers ranging from 6% to 49% [9,25,31].…”

Section: Introductionmentioning

confidence: 99%

Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

Suh

Kim

Lee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Patients with neuromuscular disease reportedly have a higher incidence of postoperative dislocation after bipolar hemiarthroplasty. Although the literature has focused on a high prevalence of preoperative neurologic conditions in patients who had dislocations after bipolar hemiarthroplasties, the relative incidence of dislocation in patients with neuromuscular disease and without is unclear. Questions/purposes We therefore (1) asked whether the incidence of postoperative dislocation after bipolar hemiarthroplasty was greater in patients with neuromuscular disease than for those without, and (2) whether function differed between the two groups, and (3) explored potential risk factors for dislocation in two groups.

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Risk Factors Influencing Mortality After Bipolar Hemiarthroplasty in the Treatment of Fracture of the Femoral Neck

Cited by 86 publications

References 0 publications

Mortality after hip fractures in Thailand

Mortality after hip fractures in Thailand

Clinical Impact of Indirect Markers of Renal Function in Elderly Patients With Hip Fracture

Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

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