Prediction of Mortality in Nonagenarians Following the Surgical Repair of Hip Fractures.
10.4055/cios.2016.8.2.140
- Author:
Ashraf FANSA
1
;
Scott HUFF
;
Nabil EBRAHEIM
Author Information
1. Department of Orthopedics, University of Toledo Medical Center, Toledo, OH, USA.
- Publication Type:Original Article
- Keywords:
Femur neck fractures;
Trochanteric fractures;
Hip fractures;
Nonagenarians
- MeSH:
Aged, 80 and over*;
Comorbidity;
Dementia;
Femoral Neck Fractures;
Femur;
Heart Failure;
Hip Fractures*;
Hip*;
Hospital Mortality;
Humans;
Lung Diseases;
Mortality*;
Residence Characteristics;
Retrospective Studies;
Social Conditions
- From:Clinics in Orthopedic Surgery
2016;8(2):140-145
- CountryRepublic of Korea
- Language:English
-
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.
