Outcomes in Nonagenarians with Hip Fractures Treated Conservatively and Surgically
https://doi.org/10.5704/MOJ.2111.004
- Author:
Malhotra R
1
;
Huq SS
1
;
Chong M
1
;
Murphy D
1
;
Daruwalla ZJ
1
Author Information
1. Department of Orthopaedics, National University Hospital of Singapore, Singapore
- Publication Type:Journal Article
- Keywords:
hip fracture, nonagenarians, mortality, morbidity, mobility
- From:Malaysian Orthopaedic Journal
2021;15(No.3):21-28
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: We aimed to assess the clinical outcomes in
nonagenarians following a hip fracture. We also further
investigated the factors that influence these outcomes, such
as method of treatment (operative versus conservative), comorbidities, and pre-morbid function.
Materials and methods: We studied 65 nonagenarians that
were identifiable from our hospital hip fracture database. We
reviewed various parameters of these patients admitted after
sustaining a hip fracture (neck of femur or intertrochanteric)
and investigated how these parameters affected patient
outcomes. The main outcomes studied were: inpatient
morbidity, and mortality at one year.
Results: Inpatient morbidity was more likely in patients with
an ASA grade of 3 to 5. Urinary tract infection was the most
common medical complication. The 1-year mortality was
15.4% and was significantly influenced by advancing age.
Surgically managed patients had a 1-year mortality rate
(14.3%) slightly less than non-operative patients (17.4%).
Post injury mobility was significantly better in those who
received operative treatment with 63% of surgical cases
regaining ambulatory status versus 7% of conservatively
managed patients.
Conclusions: We presented the outcomes of hip fractures in
an extreme age group in the population. In nonagenarians
with hip fractures surgery was associated with a 1-year
mortality rate of 14.3% which is comparable to the general
hip fracture population and less than the mortality rate of
conservatively managed patients (17.4%). The primary
advantage of surgery would be that two-thirds of patients
return to ambulatory status. This information is useful to
counsel patients and their families especially since the
elderly are often more fearful of surgical intervention.
- Full text:16.2021my1196.pdf
