The Influence of Cognitive Function on Outcome After a Hip Fracture

Söderqvist, Anita; Miedel, Ricard; Ponzer, Sari; Tidermark, Jan

doi:10.2106/00004623-200610000-00001

Cited by 20 publications

(32 citation statements)

References 37 publications

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“…In the present study, we have continued our use of the validated SPMSQ questionnaire as the assessment tool because it is both quick and easy to use -im- portant factors in an emergency care facility [8,21,22] . The findings of the present study confirm our previous results [5] showing that patients with a low SPMSQ at admission had a significantly higher mortality rate than those with normal cognitive function.…”

Section: Discussionsupporting

confidence: 92%

“…We have previously highlighted the problems involved in making a correct assessment of the patient's cognitive function without a validated instrument [20] and we have also recently shown that the use of the SPMSQ at admission to the orthopedic ward could identify patients with severe cognitive dysfunction and predict their poor outcome with regard to walking ability, ADL function and mortality [5] . In the present study, we have continued our use of the validated SPMSQ questionnaire as the assessment tool because it is both quick and easy to use -im- portant factors in an emergency care facility [8,21,22] .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have also indicated that hip fracture patients with impaired cognitive function have a further increased risk for general and fracture-related complications [4] as well as a worse functional outcome and an increased mortality rate [5] . Moreover, a recent study demonstrated that age, male sex, and the presence of three or more comorbidities on admission were associated with a high rate of postoperative complications and an increased mortality rate [6] .…”

Section: Introductionmentioning

confidence: 99%

“…The American Society of Anesthesiologists (ASA) classification [7] for assessing patients' general health and the Short Portable Mental Status Questionnaire (SPM-SQ) [8] for assessing patients' cognitive function fulfill these requirements and both instruments have been evaluated separately in clinical trials and have been shown to identify hip fracture patients with increased mortality rates [5,9,10] . However, the combined use of the ASA classification and the SPMSQ in order to identify patients at risk has not been evaluated previously in a large prospective cohort study of consecutively included hip fracture patients.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prediction of Mortality in Elderly Patients with Hip Fractures: A Two-Year Prospective Study of 1,944 Patients

Söderqvist¹,

Ekström

Ponzer³

et al. 2009

Gerontology

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124

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Background: Hip fracture patients are reported to have an increased mortality rate compared to the general population. In order to be able to reduce the morbidity and mortality after a hip fracture, our efforts to identify the patients at risk already upon admission to the hospital need to be increased. For such a risk assessment, robust, validated, and reproducible criteria are mandatory. Objective: To determine preoperative factors associated with mortality and to evaluate the combined use of the American Society of Anesthesiologists (ASA) and the Short Portable Mental Status Questionnaire (SPMSQ) to identify patients with an increased mortality rate and to create a predictive model to assess the mortality risk after hip fracture surgery. Methods: A total of 1,944 consecutive patients aged 66 years or older admitted for a hip fracture were included in a prospective cohort study with a 24-month follow-up. The patients were assessed with regard to gender, age, type of hip fracture, smoking habits, comorbidities, general physical health according to the ASA classification, and cognitive function according to the SPMSQ. A higher ASA score indicates an increasingly severe systemic disease and a lower SPMSQ score indicates an increasingly severe cognitive dysfunction. We used Cox proportional hazard models and classification trees to identify the factors associated with mortality. The predictive model was created based on factors that were significantly associated with death and all readily accessible upon admission. Results: The mortality rate during the acute hospitalization period was 4%, at 4 months 16%, and at 24 months 38%. The most prominent factors associated with mortality were high ASA scores, low SPMSQ scores, high age and male gender. The SPMSQ score provided additional information about the survival time, compared to when the ASA score was used alone. Conclusion: The combined use of the ASA classification for assessing physical health and the SPMSQ for assessing cognitive function effectively identified hip fracture patients with an increased mortality rate. We present a predictive model including age, gender, ASA, and SPMSQ that can be used to assess the mortality risk after hip fracture surgery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prediction of Mortality in Elderly Patients with Hip Fractures: A Two-Year Prospective Study of 1,944 Patients

Söderqvist¹,

Ekström

Ponzer³

et al. 2009

Gerontology

Self Cite

124

View full text Add to dashboard Cite

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“…It is a predictor of poor rehabilitation outcome after hip fracture surgery. [10][11][12] Thus, all patients were screened by a geriatrician using the Abbreviated Mental test. A score of <8 with memory dysfunction was defined as cognitive impairment.…”

Section: Methodsmentioning

confidence: 99%

Cephalomedullary Nail versus Sliding Hip Screw for Unstable Intertrochanteric Fractures in Elderly Patients

Chua

Rajamoney

Kwek

2013

J Orthop Surg (Hong Kong)

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purpose. To compare the short-term ambulatory function of elderly patients after fixation of unstable intertrochanteric fractures with either the AO-ASIF proximal femoral nail anti-rotation (PFNA) device or the dynamic hip screw (DHS). Methods. 63 patients aged ≥60 years underwent fixation for unstable intertrochanteric fractures (AO types A2 and A3) using the PFNA (n=25) or DHS (n=38). The decision for the type of implant used was based on the lead surgeon's preference, according to perceived fracture stability and clinical experience. In patients having PFNA fixation, weight bearing ambulation and rehabilitation was commenced on day 2. The extent of weight bearing was decided by the lead surgeon based on the stability of the fracture. In patients having DHS fixation, non-weight bearing and ambulation with a walking aid was commenced on day 2. Ambulatory function before injury and after surgery was measured using the Parker Mobility Score (PMS). The 2 groups were compared in terms of the PMS, ambulatory independence, and environmental mobility.

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Subjective cognitive functioning as a predictor of all cause mortality in an Israeli national sample of community dwelling older adults

Ayalon

2008

Int J Geriat Psychiatry

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The Influence of Cognitive Function on Outcome After a Hip Fracture

Cited by 20 publications

References 37 publications

Prediction of Mortality in Elderly Patients with Hip Fractures: A Two-Year Prospective Study of 1,944 Patients

Prediction of Mortality in Elderly Patients with Hip Fractures: A Two-Year Prospective Study of 1,944 Patients

Cephalomedullary Nail versus Sliding Hip Screw for Unstable Intertrochanteric Fractures in Elderly Patients

Subjective cognitive functioning as a predictor of all cause mortality in an Israeli national sample of community dwelling older adults

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