BACKGROUND: Hip fracture is a frequent injury in the elderly, and is associated with a high incidence of functional impairment, complications and mortality. OBJECTIVE: To determine kinetics of C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) in hip-fractured patients over a 1-month post-operative period; to examine the relationship of these parameters to cognition, operation type, post-operational complications, functional level 1 month post-operatively and 6-month mortality. METHODS AND SUBJECTS: 32 aged patients operated on for hip fracture were prospectively followed-up for 6 months. Fracture, type of operation and anesthetic risk were recorded. Cognition was evaluated by the Mini-Mental State Examination and pre-fracture functional level evaluated by the Katz Index of ADL. Follow-up included complications, mortality and functional outcome. CRP, fibrinogen and ESR were assessed during the first 10 h post-fracture; 48-60 h, and 7 and 30 days post-operatively, respectively. RESULTS: Only CRP kinetics were found to differ in patients with complications vs. those without, as a group (p = 0.006), and in patients suffering infections, delirium and cardiovascular complication vs. patients with no complications (p = 0.06, 0.03, 0.02, respectively). Mean (+/-SEM) CRP 48-60 h post-operatively was 20.9 +/- 2.1 and 13.1 +/- 1.6 mg/dl in complicated and uncomplicated patients, respectively (p = 0.002). The mean CRP 48-60 h post-operatively was highly correlated with the CRP area under the curve, R = 0.88 (p < 0.001). A cut-off level of 15 mg/dl for CRP, 48- 60 h post-operatively, was calculated for patients with complications (sensitivity 93%, specificity 65%, p = 0.003). CRP, fibrinogen and ESR were not related to fracture or type of operation, cognition, anesthetic risk, 1-month post-operative functioning and 6-month mortality. CONCLUSIONS: CRP measurement in elderly patients operated for hip fracture may be valuable in assessing and monitoring complications. Copyright 2004 S. Karger AG, Basel
BACKGROUND:Hip fracture is a frequent injury in the elderly, and is associated with a high incidence of functional impairment, complications and mortality. OBJECTIVE: To determine kinetics of C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) in hip-fracturedpatients over a 1-month post-operative period; to examine the relationship of these parameters to cognition, operation type, post-operational complications, functional level 1 month post-operatively and 6-month mortality. METHODS AND SUBJECTS: 32 aged patients operated on for hip fracture were prospectively followed-up for 6 months. Fracture, type of operation and anesthetic risk were recorded. Cognition was evaluated by the Mini-Mental State Examination and pre-fracture functional level evaluated by the Katz Index of ADL. Follow-up included complications, mortality and functional outcome. CRP, fibrinogen and ESR were assessed during the first 10 h post-fracture; 48-60 h, and 7 and 30 days post-operatively, respectively. RESULTS: Only CRP kinetics were found to differ in patients with complications vs. those without, as a group (p = 0.006), and in patients suffering infections, delirium and cardiovascular complication vs. patients with no complications (p = 0.06, 0.03, 0.02, respectively). Mean (+/-SEM) CRP 48-60 h post-operatively was 20.9 +/- 2.1 and 13.1 +/- 1.6 mg/dl in complicated and uncomplicated patients, respectively (p = 0.002). The mean CRP 48-60 h post-operatively was highly correlated with the CRP area under the curve, R = 0.88 (p < 0.001). A cut-off level of 15 mg/dl for CRP, 48- 60 h post-operatively, was calculated for patients with complications (sensitivity 93%, specificity 65%, p = 0.003). CRP, fibrinogen and ESR were not related to fracture or type of operation, cognition, anesthetic risk, 1-month post-operative functioning and 6-month mortality. CONCLUSIONS:CRP measurement in elderly patients operated for hip fracture may be valuable in assessing and monitoring complications. Copyright 2004 S. Karger AG, Basel
Authors: Katie J Sheehan; Boris Sobolev; Pierre Guy; Lisa Kuramoto; Suzanne N Morin; Jason M Sutherland; Lauren Beaupre; Donald Griesdale; Michael Dunbar; Eric Bohm; Edward Harvey Journal: CMAJ Date: 2016-10-17 Impact factor: 8.262
Authors: Simon T Dillon; Sarinnapha M Vasunilashorn; Long Ngo; Hasan H Otu; Sharon K Inouye; Richard N Jones; David C Alsop; George A Kuchel; Eran D Metzger; Steven E Arnold; Edward R Marcantonio; Towia A Libermann Journal: Biol Psychiatry Date: 2016-03-25 Impact factor: 13.382
Authors: Maya E Matheny; Ram R Miller; Michelle D Shardell; William G Hawkes; Eric J Lenze; Jay Magaziner; Denise L Orwig Journal: J Am Geriatr Soc Date: 2011-12 Impact factor: 5.562
Authors: Sarinnapha M Vasunilashorn; Simon T Dillon; Sharon K Inouye; Long H Ngo; Tamara G Fong; Richard N Jones; Thomas G Travison; Eva M Schmitt; David C Alsop; Steven D Freedman; Steven E Arnold; Eran D Metzger; Towia A Libermann; Edward R Marcantonio Journal: J Am Geriatr Soc Date: 2017-05-26 Impact factor: 5.562