Prediction of Mortality in Nonagenarians Following the Surgical Repair of Hip Fractures
Clinics in Orthopedic Surgery
;
: 140-145, 2016.
Article
in English
| WPRIM
| ID: wpr-11086
ABSTRACT
BACKGROUND:
The purpose of this study is to report on the mortality of nonagenarians who underwent surgical treatment for a hip fracture, specifically in regards to preexisting comorbidities. Furthermore, we assessed the effectiveness of the Deyo score in predicting such mortality.METHODS:
Thirty-nine patients over the age of 90 who underwent surgical repair of a hip fracture were retrospectively analyzed. Twenty-six patients (66.7%) suffered femoral neck fractures, while the remaining 13 (33.3%) presented with trochanteric type fractures. Patient charts were examined to determine previously diagnosed patient comorbidities as well as living arrangements and mobility before and after surgery.RESULTS:
Deyo index scores did not demonstrate statistically significant correlations with postoperative mortality or functional outcomes. The hazard of in-hospital mortality was found to be 91% (p = 0.036) and 86% (p = 0.05) less in patients without a history of congestive heart failure (CHF) and chronic pulmonary disease (CPD), respectively. Additionally, the hazard of 90-day mortality was 88% (p = 0.01) and 81% (p = 0.024) less in patients without a history of dementia and CPD, respectively. The hazard of 1-year mortality was also found to be 75% (p = 0.01) and 80% (p = 0.01) less in patients without a history of dementia and CPD, respectively. Furthermore, dementia patients stayed in-hospital postoperatively an average of 5.3 days (p = 0.013) less than nondementia patients and only 38.5% returned to preoperative living conditions (p = 0.036).CONCLUSIONS:
Nonagenarians with a history of CHF and CPD have a higher risk of in-hospital mortality following the operative repair of hip fractures. CPD and dementia patients over 90 years old have higher 90-day and 1-year mortality hazards postoperatively. Dementia patients are also discharged more quickly than nondementia patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Social Conditions
/
Comorbidity
/
Residence Characteristics
/
Retrospective Studies
/
Mortality
/
Hospital Mortality
/
Dementia
/
Femoral Neck Fractures
/
Femur
/
Heart Failure
Type of study:
Observational study
/
Prognostic study
Limits:
Aged
/
Aged80
/
Humans
Language:
English
Journal:
Clinics in Orthopedic Surgery
Year:
2016
Type:
Article
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