Montserrat Barceló1, Esther Francia2, Carlos Romero3, Domingo Ruiz4, Jordi Casademont5, Olga H Torres6. 1. Internal Medicine Department, Geriatric Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. Electronic address: mbarcelot@santpau.cat. 2. Internal Medicine Department, Geriatric Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. Electronic address: EFrancia@santpau.cat. 3. Internal Medicine Department, Geriatric Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. Electronic address: cromeroc@santpau.cat. 4. Internal Medicine Department, Althaia Xarxa Assistencial Universitària Manresa, Universitat Autònoma de Barcelona, Spain. Electronic address: druizh@althaia.cat. 5. Internal Medicine Department, Geriatric Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. Electronic address: JCasademont@santpau.cat. 6. Internal Medicine Department, Althaia Xarxa Assistencial Universitària Manresa, Universitat Autònoma de Barcelona, Spain. Electronic address: OTorres@santpau.cat.
Abstract
INTRODUCTION: Centenarians and nonagenarians constitute a rapidly growing age group in Western countries and they are expected to be admitted to hospital with hip fractures. The aim of this study was to compare outcomes of centenarian and nonagenarian patients following a hip fracture and to identify risk factors related to in-hospital and post-discharge mortality in both groups. PATIENTS AND METHODS: A prospective evaluation of centenarian patients and nonagenarian controls admitted to a tertiary university hospital in Barcelona with hip fractures over a period of 5 years and 9 months. Baseline characteristics and outcomes in both patient groups were compared. Variables associated with in-hospital, 30-day, 3-month and 1-year mortality were also analyzed. RESULTS: Thirty-three centenarians and 82 nonagenarians were included. The most relevant statistically significant differences found were: Barthel index at admission (61.90 vs. 75.22), number of drugs before admission (4.21vs 5.55), in-hospital complication rates (97 vs. 78%), readmissions at 3 months and 1 year (0 vs 11.7% and 3.4 vs. 19.5% respectively) and mortality at 3 months and 1 year (41.4 vs. 20.8% and 62.1 vs. 29.9%, respectively). Mean number of complications, rapid atrial fibrillation, mean age, and urinary tract infection were risk factors associated with mortality. CONCLUSIONS: Centenarian patients had similar in-hospital outcomes to nonagenarians, but experienced more complications and twice the 3-month and 1-year mortality rate. The mean number of complications was the risk factor most consistently related to in-hospital and post-discharge mortality. These findings emphasize the need to improve care in very old patients to prevent complications.
INTRODUCTION: Centenarians and nonagenarians constitute a rapidly growing age group in Western countries and they are expected to be admitted to hospital with hip fractures. The aim of this study was to compare outcomes of centenarian and nonagenarian patients following a hip fracture and to identify risk factors related to in-hospital and post-discharge mortality in both groups. PATIENTS AND METHODS: A prospective evaluation of centenarian patients and nonagenarian controls admitted to a tertiary university hospital in Barcelona with hip fractures over a period of 5 years and 9 months. Baseline characteristics and outcomes in both patient groups were compared. Variables associated with in-hospital, 30-day, 3-month and 1-year mortality were also analyzed. RESULTS: Thirty-three centenarians and 82 nonagenarians were included. The most relevant statistically significant differences found were: Barthel index at admission (61.90 vs. 75.22), number of drugs before admission (4.21vs 5.55), in-hospital complication rates (97 vs. 78%), readmissions at 3 months and 1 year (0 vs 11.7% and 3.4 vs. 19.5% respectively) and mortality at 3 months and 1 year (41.4 vs. 20.8% and 62.1 vs. 29.9%, respectively). Mean number of complications, rapid atrial fibrillation, mean age, and urinary tract infection were risk factors associated with mortality. CONCLUSIONS: Centenarian patients had similar in-hospital outcomes to nonagenarians, but experienced more complications and twice the 3-month and 1-year mortality rate. The mean number of complications was the risk factor most consistently related to in-hospital and post-discharge mortality. These findings emphasize the need to improve care in very old patients to prevent complications.
Authors: Alexander Isla; David Landy; Robert Teasdall; Peter Mittwede; Ashley Albano; Paul Tornetta; Mohit Bhandari; Arun Aneja Journal: Eur J Orthop Surg Traumatol Date: 2022-02-23
Authors: Viviane Cristina Uliana Peterle; Maria Rita Carvalho Garbi Novaes; Paulo Emiliano Bezerra Junior; João Carlos Geber Júnior; Rodrigo Tinôco Magalhães Cavalcante; Jurandi Barrozo da Silva Junior; Ray Costa Portela; Ana Patricia de Paula Journal: PLoS One Date: 2022-08-12 Impact factor: 3.752