Comorbid Profile Rather than Age Determines Hip Fracture Mortality in a Nonagenarian Population
| Autor: | Lewis Collins, Ariel Goldman, Adam Graver, Sara L. Merwin, Nina Kohn |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Sports medicine Population Poison control Injury prevention medicine postoperative Orthopedics and Sports Medicine orthopedic education Geriatrics education.field_of_study Hip fracture geriatrics business.industry Original Article/CME General surgery fragility fractures medicine.disease Comorbidity mortality Surgery comorbidity Orthopedic surgery business |
| Zdroj: | HSS Journal |
| ISSN: | 1556-3316 |
| Popis: | Background In light of poor outcomes with nonoperative management of hip fractures, orthopedic surgeons are faced with difficult decisions about which patients are too ill or too old for surgical treatment. Questions/Purposes This study sought to investigate if patients over 90 years had different preoperative laboratory, clinical, and injury characteristics than younger patients with the same injury. We compared our cohort with previously published data. We wished to identify if there were pre-injury risk factors associated with 30-day mortality, which could be modified to enhance postoperative outcomes. Methods This is a retrospective review of 198 operatively managed hip fractures in patients 75 years or older. We collected data on demographics, select preoperative laboratory values, injury type, comorbidities, and 30-day mortality. Results Eleven (5.6%) of the cohort died within 30 days of surgery, 6.3% in the younger group, and 3.7% in the older group; the difference was not statistically significant. For baseline characteristics, there was no difference between the age groups for pre-injury comorbidities, hemoglobin, serum albumin, BUN, prevalence of UTI, or fracture type. A total of 67 (35.8%) patients had evidence of UTI on admission. Conclusions These findings reveal that in our dichotomized cohort, pre-injury characteristics were similar and age alone was not an independent predictor of mortality. These data may inform decision-making for orthopedic surgeons and the medical providers who consult to optimize these patients for surgery. We identified high rates of UTI in both age groups, a potentially remediable factor to optimize outcomes in hip fracture surgery in elderly patients. Electronic supplementary material The online version of this article (doi:10.1007/s11420-015-9435-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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