Factors which influence postoperative mortality after hip fracture

Medicinski fakultet, Klinicki centar Kragujevac, Kragujevac.
Vojnosanitetski pregled. Military-medical and pharmaceutical review (Impact Factor: 0.29). 01/2006; 63(1):49-53.
Source: PubMed


One of the most significant predictors of mortality after hip fractures is cognitive impairment (dementia). The aim of this study was to report the results of a prospective study of the influence of some factors on six-month mortality in elderly patients with hip fractures.
The elderly patients with hip fracture were assessed on admission to the hospital using the measures of cognitive function, the mobility before the fracture, and physical comorbidity, the type of fracture and the place of the injury. Six months later, we checked how many of them were still alive.
We performed univariate and multivariate analyses in 132 patients and found that the most significant predictors of six-month mortality were dementia, comorbidity, and prefacture mobility.
A comprehensive physical and mental health assessment of an elderly patient after hip fracture could predict mortality. A good examination of cognitive functioning could be very useful in choosing the optimal treatment for this type of patients.


Available from: Dragana Ristic, Mar 07, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To identify factors that could be associated to increased mortality in patients over 60 years of age with a hip fracture that undergo surgery. Material and method: This is a prospective study of 90 patients carried out with the aim of identifying what are in our environment the risk factors associated to increased mortality in elderly patients subjected to surgery further to sustaining a hip fracture. Inclusion criteria were as follows: being older than 60 years of age, not having a pathological fracture and staying alive during hospitalization. All patients were followed up for one year or until their passing away. Risk factors analyzed in the study were: age, gender, general health status, mental impairment and functional status prior to fracture, as well as fracture type. Conclusions: Gender and prior health status were the risk variables for which statistically significant differences were observed in terms of mortality at one year. In contrast, age and pre-fracture mental status stayed just below the statistical significant threshold for p<0.05. Prior functional status and fracture type were not identified as risk factors.
    Revista Espanola de Cirugia Ortopedica y Traumatologia 07/2009; 53(4):237-241. DOI:10.1016/S1988-8856(09)70171-3
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To identify risk factors associated with increased mortality in elderly patients not operated after suffering hip fracture. Materials and methods: A one-year prospective study in 11 I patients suffering hip fracture and not operated. The inclusion criteria were age over 60 years, not suffering a pathological fracture and not dying during hospital stay. All were followed for one year or until death. The risk factors analysed in the study were: age, sex, general health condition, mental impairment, performance status prior to the fracture and type of fracture. Results: The main risk factor was the general condition impaired before the fracture. The age over S3 years and mental impairment were borderline statistically significant risk factors (p<0.05). Only 42 patients (37.8%) lived at one year of the fracture. Conclusions: Conservative management of hip fractures involves a high mortality at one year of the fracture, the previous general condition being the primary risk factor.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Unstable intertrochanteric (IT) fractures, especially fractures with a reverse or transverse fracture line, have tendencies to make significant impaction on shortening of the femoral neck and lower extremity. The biomechanical complexity of the fracture, the type and the position of the implant are known to influence postoperative outcome. The aim of this study was to compare characteristics of two versions of dynamic hip implants in controlling the dynamization of unstable IT fractures of the femur. In the prospective study that included 1,115 patients with fractures of the proximal femur, 61 patients had IT fractures with a reverse or transverse fracture line. All the patients were treated surgically with the same implant in two versions: Dynamic Hip Screw - DHS-MB-S implant with a rigid part of standard length (40 mm) and DHS-MB-I implant, with a rigid part of the implant individualized for each patient depending on the transverse diameter of the proximal femur. The patients were under gradual radiographic and clinical control. Six months postoperatively we measured the length of the extremity and the degree of the medialization of the distal part of the femur. All the fractures healed six months after the operation. Medialization and shortening of the extremity were significantly less in the group with fractures fixed by the DHS-MB-I implant, in which length of the rigid part of the implant was preoperatively measured individually for each patient. In order to achieve a desired functional result, the control of dynamisation in unstable IT fractures is significant in the fixation of these fractures of the femur. We presented possible methods to realize it by the contact of the rigid part of our implant with medial cortex of the proximal fragment of the femur.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 05/2011; 68(5):399-404. DOI:10.2298/VSP1105399B · 0.29 Impact Factor
Show more