Factors influencing early and long-term survival following hip fracture among nonagenarians
| Autor: | Jasun Kai Li, Anoop N Koshy, Dong-Kyu Lee, Daryl A Jones, Chong Oon Tan, Peter Le, Bobby Ou Yang, Sarah Klink, Laurence Weinberg, Rinaldo Bellomo, Luka Cosic |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Diseases of the musculoskeletal system Anaesthesia Postoperative Complications Risk Factors Internal medicine medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Nonagenarian Retrospective Studies Aged 80 and over Orthopedic surgery Hip fracture business.industry Hip Fractures Mortality rate Hazard ratio Retrospective cohort study medicine.disease Fracture RC925-935 Heart failure Nonagenarians Cohort Surgery Complication business RD701-811 Research Article |
| Zdroj: | Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-11 (2021) Journal of Orthopaedic Surgery and Research |
| Popis: | Background The outcomes of nonagenarian patients undergoing orthopaedic surgery are not well understood. We investigated the 30-day mortality after surgical treatment of unilateral hip fracture. The relationship between postoperative complications and mortality was evaluated. Methods We performed a single-centre retrospective cohort study of nonagenarian patients undergoing hip fracture surgery over a 6-year period. Postoperative complications were graded according to the Clavien–Dindo classification. Correlation analyses were performed to evaluate the relationship between mortality and pre-specified mortality risk predictors. Survival analyses were assessed using Cox proportional hazards regression modelling. Results The study included 537 patients. The 30-day mortality rate was 7.4%. The mortality rate over a median follow-up period of 30 months was 18.2%. Postoperative complications were observed in 459 (85.5%) patients. Both the number and severity of complications were related to mortality (p p = 0.034), were at higher ASA risk (p = 0.010) and were more likely to have preoperative congestive heart failure (p p = 0.003). Up to 21 days from admission, any increase in complication severity was associated significantly greater mortality [adjusted hazard ratio: 3.0 (95% CI 2.4, 3.6; p Conclusion In a nonagenarian cohort of patients undergoing hip fracture surgery, 30-day mortality was 7.4%, but 30-month mortality rates approached one in five patients. Postoperative complications were independently associated with a higher mortality, particularly when occurring early. |
| Databáze: | OpenAIRE |
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