Mortality Rate and Ten Years Survival of Elderly Patients Treated with Total Hip Arthroplasty for Femoral Neck Fractures
https://doi.org/10.5704/MOJ.2107.020
- Author:
Nanchappan NS
1
;
Chopra S
1
;
Samuel A
1
;
Therumurtei L
1
;
Ganapathy SS
2
Author Information
1. Department of Orthopaedics, Hospital Sultanah Bahiyah, Alor Setar, Malaysia
2. Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
- Publication Type:Journal Article
- Keywords:
total hip arthroplasty (THA), surgical timing, mortality, survival analysis
- From:Malaysian Orthopaedic Journal
2021;15(No.2):136-142
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Mortality following traumatic femoral neck
fractures in the elderly (age >60 years) is influenced by many
factors. Addressing some of them may reduce the mortality
rate thus improving patient survival and quality of life.
Materials and methods: This study was a retrospective
research using data collected from Hospital Sultanah
Bahiyah, Kedah between the years 2008-2018. We measured
outcomes such as age, gender, hospital stay, default rate,
ambulation post-surgery, American Society of
Anaesthesiologists score (ASA) and surgical timing in
correlation with mortality rate and 10-year survival of
elderly patients treated with Total Hip Arthroplasty for
femoral neck fractures in this centre.
Results: A total of 291 traumatic femoral neck fractures
aged above 60 years post total hip arthroplasty performed
were included. There was higher number of female (n =233)
compared to male (n=53) Estimated 10 years survival from
Kaplan Meier was 42.88% (95% CI: 33.15, 52.54). One year
mortality rate in our study was found to be 18.9%. The
average time to event was 7.1 years (95% CI:33.15, 52.24)
with a mean age group of 75.
Discussion: Total hip arthroplasty patients not ambulating
after surgery had a 4.2 times higher hazard ratio compared to
ambulators. Those with pre-existing systemic disease (ASA
III and IV) were found to have the highest hazard ratio,
almost five times that of healthy patients, after adjusting for
confounding factors. Delay of more than seven days to
surgery was found to be a significant factor in 10-year
survival with a hazard ratio of 3.8, compared to surgery
performed earlier.
Conclusion: Delay of more than 7 days to surgery in 10
years survival was significant with high hazard ratio. It is a
predictor factor for survival in 10 years. A larger sample size
with a prospective design is required to confirm our findings
regarding “unacceptable surgical timing” for femoral neck
fractures in patients above 60 years of age.
- Full text:16.2021my1186.pdf
