Similar mortality rates in hip fracture patients over the past 31 years

Mundi, Simran; Pindiprolu, Bharadwaj; Simunovic, Nicole; Bhandari, Mohit

doi:10.3109/17453674.2013.878831

Cited by 212 publications

(170 citation statements)

References 17 publications

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“…1-year mortality after treatment of femoral neck fractures with internal fixation or hip arthroplasty has been estimated to be approximately 20%, with no obvious change over the last 3 decades (Mundi et al. 2014). Early mortality after THA performed in patients with femoral neck fracture appears to be lower than with hemiarthroplasty or internal fixation, presumably due to selection of more frail patients for the latter 2 procedures.…”

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confidence: 99%

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

Hailer¹,

Garland²,

Rogmark³

et al. 2016

Acta Orthopaedica

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Background and purpose — Early postoperative mortality is relatively high after total hip arthroplasty (THA) that has been performed due to femoral neck fracture. However, this has rarely been investigated after adjustment for medical comorbidity and comparison with the mortality in an age-matched population. We therefore assessed early mortality in hip fracture patients treated with a THA, in the setting of a nationwide matched cohort study.Patients and methods — 24,699 patients who underwent THA due to a femoral neck fracture between 1992 and 2012 were matched with 118,518 controls. Kaplan-Meier survival analysis was used to calculate cumulative unadjusted survival, and Cox regression models were fitted to compute hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for age, sex, comorbidity, and socioeconomic background.Results — 90-day survival was 96.3% (95% CI: 96.0–96.5) for THA cases and 98.7% (95% CI: 98.6–98.8) for control individuals, giving an adjusted HR of 2.2 (95% CI: 2.0–2.4) for THA cases compared to control individuals. Comorbidity burden increased in THA cases over time, but the adjusted risk of death within 90 days did not differ statistically significantly between the time periods investigated (1992–1998, 1999–2005, and 2006–2012). A Charlson comorbidity index of 3 or more, an American Society of Anesthesiologists (ASA) grade of 3 and above, male sex, an age of 80 years and above, an income below the first quartile, and a lower level of education were all associated with an increased risk of 90-day mortality.Interpretation — The adjusted early mortality in femoral neck fracture patients who underwent THA was about double that in a matched control population. Patients with femoral neck fracture but with no substantial comorbidity and an age of less than 80 years appear to have a low risk of early death. Patients older than 80 years and those with a Charlson comorbidity index of more than 2 have a high risk of early death, and such patients would perhaps benefit from treatment strategies other than THA, but this should be investigated further.

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confidence: 99%

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

Hailer¹,

Garland²,

Rogmark³

et al. 2016

Acta Orthopaedica

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“…Complications in the surgical treatment of elderly patients' hip fractures are frequent, with rates ranging from 8 to 40% according to the current literature [1,2,3,4,5]. In addition, the long-term results following hip fracture surgery are poor, including the loss of independence in approximately half of the cases [6] and mortality rates of up to 37% over the first year following surgery [7,8,9]. …”

Section: Introductionmentioning

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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“…Avoiding complications in hip fracture surgery in elderly patients is of paramount importance since reoperation has been associated with increased morbidity and mortality [59]. Performing good quality surgery should be the ultimate goal but it might be challenging in elderly people due to difficulties in providing reliable fixation in osteoporotic bone.…”

Section: Tips and Tricks To Avoid Complicationsmentioning

confidence: 99%

Common complications in hip fracture surgery: Tips/tricks and solutions to avoid them

Tosounidis

Castillo

Kanakaris

et al. 2015

Injury

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Similar mortality rates in hip fracture patients over the past 31 years

Cited by 212 publications

References 17 publications

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

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

Common complications in hip fracture surgery: Tips/tricks and solutions to avoid them

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