Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years: The Factors Influencing the Postoperative Mortality

ABSTRACT

PURPOSE: We wanted to evaluate the factors that influence the one-year mortality rate after bipolar hemiarthroplasty in elderly patients over 90 years of age and who had hip fractures. MATERIALS AND METHODS: In this retrospective study, we enrolled 42 cases (29 females and 12 males) that were treated by bipolar hemiarthroplasty for hip fractures between April 1999 and April 2008. The mean age was 94 (range 90~101) years. We compared such variables as age, gender, BMD (bone mineral density), the ASA (American Society of Anesthesiologists) score, the type of fracture, the operation time, the type of anesthesia, the length of the ICU (intensive care unit) care, the length of hospitalization, operative delay and the postoperative ambulatory capability between the one-year mortality group and the control group (alive over a minimum of 1-year), and we investigated the risk factors related to one-year mortality. RESULTS: The one-year mortality rate was 32%. There were significant relationships between the postoperative one-year mortality and the ASA score, the length of the ICU care, operative delay and the postoperative ambulatory capability. The one-year mortality rate in the trochanteric fracture group was significantly higher than that in the neck fracture group. However, there were no relationships between the one-year mortality and age, gender, BMD, the length of operation, the type of anesthesia and the length of the hospitalization. CONCLUSION: The preoperative ASA score was significantly higher in the one-year mortality group among the elderly patients over 90 years of age and who were treated with bipolar hemiarthroplasty for hip fractures. The length of the ICU care, operative delay and the postoperative ambulatory capability were significantly associated with one-year mortality, and so all of these should be considered as postoperative prognostic factors.