ABSTRACT
OBJECTIVES: To determine the morbidity and mortality outcomes of patients presenting with a fractured neck of femur in an Australian context. Peri-operative variables related to unfavourable outcomes were identified to allow planning of intervention strategies for improving peri-operative care. METHODS: We performed a retrospective observational study of 185 consecutive adult patients admitted to an Australian metropolitan teaching hospital with fractured neck of femur between 2009 and 2010. The main outcome measures were 30-day and one-year mortality rates, major complications and factors influencing mortality. RESULTS: The majority of patients were elderly, female and had multiple comorbidities. Multiple peri-operative medical complications were observed, including pre-operative hypoxia (17%), post-operative delirium (25%), anaemia requiring blood transfusion (28%), representation within 30 days of discharge (18%), congestive cardiac failure (14%), acute renal impairment (12%) and myocardial infarction (4%). Mortality rates were 8.1% at 30 days and 21.6% at one year. Factors predictive of one-year mortality were American Society of Anesthesiologists (ASA) score (odds ratio (OR) 4.2 (95% confidence interval (CI) 1.5 to 12.2)), general anaesthesia (OR 3.1 (95% CI 1.1 to 8.5)), age > 90 years (OR 4.5 (95% CI 1.5 to 13.1)) and post-operative oliguria (OR 3.6 (95% CI 1.1 to 11.7)). CONCLUSIONS: Results from an Australian metropolitan teaching hospital confirm the persistently high morbidity and mortality in patients presenting with a fractured neck of femur. Efforts should be aimed at medically optimising patients pre-operatively and correction of pre-operative hypoxia. This study provides planning data for future interventional studies. Cite this article: Bone Joint Res 2013;2:162-8.
Subject(s)
Cytochalasin B/pharmacology , Megakaryocytes/physiology , Animals , Bone Marrow Cells/cytology , Bone Marrow Cells/physiology , Cell Adhesion , In Vitro Techniques , Male , Megakaryocytes/cytology , Megakaryocytes/drug effects , Membrane Potentials/drug effects , Membrane Potentials/physiology , Patch-Clamp Techniques , Rats , Rats, WistarABSTRACT
Simultaneous addition of ADP plus Melatonin induces apparent emission of platelets by rat's megacariocyte in vitro.
Subject(s)
Adenosine Diphosphate/pharmacology , Megakaryocytes/drug effects , Melatonin/pharmacology , Animals , Blood Platelets/drug effects , Blood Platelets/metabolism , Drug Interactions , RatsABSTRACT
Melatonin induces an apparent platelets emission by rat's megakaryocytes in vitro.
Subject(s)
Blood Platelets/drug effects , Melatonin/pharmacology , Animals , Blood Platelets/metabolism , In Vitro Techniques , Megakaryocytes/metabolism , RatsABSTRACT
Normal rat's recent bone marrow has been suspended in an isoionic, oxygenated, warmed solution; platelets production by megakaryocytes has never been verified.
