The mortality and social prognosis of hip fractures

Abstract

A prospective 5-year study was carried out of 143 patients with trochanteric fractures treated by Ender nailing. A detailed proforma was used for multifactorial analysis in order to identify the prognostic indicators of social function and quality of life of the patients. Their mean age was 81 years and the female: male ratio 7:1. The mortality rate 6 months after injury was 23%, and at the end of 5 years 45.5%. The patients surviving the first 6 months had the same life expectancy as the general population. Dementia, associated disease, medical complications, total dependency and age were the most significant predictors of mortality. These factors, with pressure sores and poor rehabilitation, were also significant in determining the prognosis of social function. Deterioration of health status was seen in 36% during the first 6 months after injury and 40% showed deterioration of their social condition within this period. Later, most survivors recovered and were restored to their previous state. Postoperative geriatric care is essential to achieve this aim.

Chronic subdural hematoma in the elderly: not a benign disease

“…Pitto 15 found a 6% in-hospital mortality rate, but the 6-month mortality rate was 23% in 143 hip fracture repair cases in which the average patient age was 81 years. Pitto also calculated that those surviving to 6 months had an life expectancy equivalent to the general population.…”

Functional comparison between uncemented Austin-Moore hemiarthroplasty and osteosynthesis with three screws in displaced femoral neck fractures?a matched-pair study of 168 patients

“…By this time, about 80% of patients who had been admitted from their own homes had returned there [2]. On the other hand, a considerable number of reoperations are done after 4 months, and the patients were therefore followed up for 1 year [5,16]. Slightly more OS patients had returned home by 4 months compared to HA patients.…”

Postoperative ambulatory level after hip fracture in the elderly predicts survival rate

“…Many factors have been implicated that affect the survival rate after hip fracture such as advanced age, preexisting disease, dementia, operative delay and ambulatory level [2,3,4,5,6,7,9,11,12,13,14,15,17,18,19,20]. Although many reports have demonstrated the relationship between pre-or postoperative ambulatory level and survival rate after hip fracture in the elderly [1,2,4,7,14,15], few [10] evaluated which ambulatory level reflected the survival rate better.…”

“…There are many factors which affect the survival rate after hip fracture including advanced age, preexisting disease, dementia, time until operation, and activity level before or after the operation. Some reports have concluded that institutionalized living, dementia, advanced age, operative delay, and inability to walk affect the outcome adversely [2,3,4,5,6,7,9,11,12,13,14,15,17,18,19,20].…”