Hip Fracture in Nonagenarians: Characteristics and Factors Related to 30-Day Mortality in 1177 Patients
| Autor: | José Antonio Serra-Rexach, Maite Vidán-Astiz, Javier Ortiz-Alonso, Lydia Abasolo, Nuria Montero-Fernández, Jennifer Mayordomo-Cava |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Heart disease Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Medicine Dementia Humans Orthopedics and Sports Medicine Aged Retrospective Studies Polypharmacy Aged 80 and over 030222 orthopedics Hip fracture business.industry Hip Fractures Mortality rate Respiratory infection medicine.disease Treatment Outcome Cohort Female business Cohort study |
| Zdroj: | The Journal of arthroplasty. 35(5) |
| ISSN: | 1532-8406 |
| Popis: | Objectives The number of nonagenarian patients with hip fracture is increasing. The goals of this study were to describe the characteristics and in-hospital course of a cohort of 1177 nonagenarians admitted for hip fracture compared with younger patients, and to identify risk factors for 30-day mortality after admission. Methods A retrospective observational cohort study including patients 65 years of age or older admitted for hip fracture during various periods from February 1997 to December 2016. We defined 3 age groups: 65–79, 80–89, and 90 years and older. We included sociodemographic variables, baseline functional status, comorbidities, fracture and surgical characteristics, postoperative complications, length of stay, in-hospital and 30-day mortality. Multiple logistic regression analysis was used to study risk factors for 30-day mortality in surgically treated nonagenarians. Results Nonagenarians were more likely to be women and to have dementia and heart disease. Some 72% walked independently before the fracture. The most relevant treatable risk factors for 30-day mortality in nonagenarians (in terms of higher Odd Ratio [OR]) were developing respiratory infection (OR 4.56, 95%CI 2.73–7.63). Better prefracture functional status (higher Katz score; OR 0.83, 95% CI 0.74–0.92) and spinal anesthesia (OR 0.19, 95%CI 0.05–0.68) decreased risk of 30-day mortality. Conclusions Nonagenarian patients with hip fracture differ significantly from younger patients concerning clinical characteristics, medical complications, and in-hospital and 30-day mortality rates. We identified several variables on which we could act to reduce 30-day mortality, such as respiratory infection, electrolyte disorders, polypharmacy, cardiac arrhythmia, and spinal anesthesia. |
| Databáze: | OpenAIRE |
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