Outcome analysis of hip fracture surgery in patients aged 90 and over / 中华老年医学杂志

ABSTRACT

Objective To investigate the outcomes of hip fracture surgery in patients aged 90 and over. Methods Clinical data of patients aged 90 years and over admitted to our hospital from January 2012 to December 2016 were collected. The data included age ,gender ,comorbidities ,type of fracture , timing of surgery , operation method , complications , mortality , and functional outcomes.Differences in these items were compared between patients who died one year after surgery and those who survived.Independent risk factors for one-year mortality were analyzed. Results A total of 101 patients who met the inclusion criteria were enrolled in the study. There were 43 males and 58 females ,with a mean age of (92.3 ± 2.7)years ;66 cases had intertrochanteric fractures and 35 cases had femoral neck fractures ;in 45 cases patients could walk independently and in 56 cases walking aids were needed before operation. The mortalities at 30 days ,6 months ,and 1 year post-operation were 8.9% (9 cases ) ,16.8% (17 cases ) ,and 26.7% (27 cases ) ,respectively. Pulmonary infection and malnutrition were the main causes of death. Ambulation with walking aids was an independent risk factor for 1-year mortality (OR=7.298 ,P=0.020). Conclusions Surgery for the treatment of hip fractures in patients aged 90 and over is appropriate. Poor preinjury mobility is an independent risk factor for mortality after operation. The main causes of death are pulmonary infection and malnutrition ,and frailty plays an important role in this process.