Preinjury ambulatory status is associated with 1-year mortality following lateral compression Type I fractures in the geriatric population older than 80 years
| Autor: | Edward K. Rodriguez, Beverlie L. Ting, Lindsay M Herder, Katiri Wagner, David Zurakowski, Paul Appleton |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Population Walking Critical Care and Intensive Care Medicine Risk Assessment Cohort Studies Fracture Fixation Internal Postoperative Complications Trauma Centers Cause of Death Fracture fixation Activities of Daily Living Fractures Compression Medicine Humans education Survival rate Geriatric Assessment Retrospective Studies Aged 80 and over education.field_of_study Rehabilitation business.industry Hip Fractures Mortality rate Medical record Retrospective cohort study Prognosis Survival Rate Logistic Models Treatment Outcome Multivariate Analysis Preoperative Period Physical therapy Surgery Female business Cohort study Follow-Up Studies |
| Zdroj: | The journal of trauma and acute care surgery. 76(5) |
| ISSN: | 2163-0763 |
| Popis: | Background Lateral compression pelvic Type I fractures in the elderly population are most often low-energy osteoporosis related fractures. Previous literature comparing pelvic fractures in young versus elderly patients called into question the general consideration of these injuries as benign injuries with favorable prognoses; however, the geriatric population older than 80 years is often underrepresented. This article focuses on the mortality and functional outcomes after low-energy pelvic fractures in a population of patients older than 80 years. Methods We prescreened potential subjects in a Level I trauma institution's electronic medical record database between January 1, 2002, and April 30, 2012, to identify isolated lateral compression Type 1 fractures treated nonoperatively in patients older than 80 years. This study was composed of a retrospective review of medical records followed by a prospective survey data collection to examine mechanisms of injury, length of hospital stay, complications, medical comorbidities, ambulatory function, living situation, pain, and 1 year mortality rates. Results We present a large case series of 85 patients older than 80 years and report a 1-year mortality rate of 20%. We found that patients who were household ambulators or nonfunctional ambulators were five times more likely (24.4% vs. 6.1%) to die within 1 year after injury. Multivariate logistic regression confirmed that the risk of 1-year mortality was significantly higher for household-bound patients compared with community ambulators, independent of sex, smoking, Charlson comorbidity index, or length of hospital stay. Conclusion This is the first study to demonstrate a difference in 1-year mortality between patients who were community ambulators versus those who were household ambulators or nonfunctional ambulators before injury. With our aging population, these findings have important implications. Maintenance of general conditioning and early mobilization with physical therapy after injury is a key part of geriatric orthopedic rehabilitation. Level of evidence Prognostic and epidemiologic, level IV. |
| Databáze: | OpenAIRE |
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