Jaime A Leal1, Luisa F Garcia2, Omar R Peña2, Amparo Gomez-Gelvez2. 1. Department of Orthopedics and Traumatology, Hospital Universitario de La Samaritana, Carrera 8 # 0 - 29 Sur, 110411, Bogotá, D.C., Colombia. jalealcamacho@hotmail.com. 2. Department of Orthopedics and Traumatology, Hospital Universitario de La Samaritana, Carrera 8 # 0 - 29 Sur, 110411, Bogotá, D.C., Colombia.
Abstract
BACKGROUND: The increase in the population over 90 years old suggests an expected surge in the number of extreme elderly patients sustaining hip fractures. OBJECTIVE: The aim of this study is to identify factors associated with 1-year mortality and determine the conditions that are associated with an unfavorable survival outcome in nonagenarians. DESIGN: Cross-sectional study SUBJECTS: Nonagenarian patients presenting with hip fractures between 2013 and 2018. METHODS: Bivariate and multivariate analyses were performed to identify variables associated with mortality, and a survival analysis was conducted to determine whether the Charlson Comorbidity Index (CCI) is associated with mortality. RESULTS: A total of 127 patients, with a mean age of 92.84 years was assessed, identifying 1-year mortality rate in 53.5% of patients. According to the bivariate analysis, requirement of postoperative vasopressor support, transfusion, decompensated heart failure and general anesthesia were associated with a higher probability of 1-year mortality after surgery. Body mass index, health status, dementia or CCI ≥ 3 were not associated with mortality. Similarly, the Kaplan-Meier survival analysis showed no difference in mortality rate of patients with CCI ≥ 3 (p = 0.282). CONCLUSION: Patients older than 90 years with hip fractures have higher mortality rates per year than younger patients. Some associations were found, but more studies are needed to reach final conclusions, which could help identify higher-risk patients and be able to implement additional measures.
BACKGROUND: The increase in the population over 90 years old suggests an expected surge in the number of extreme elderly patients sustaining hip fractures. OBJECTIVE: The aim of this study is to identify factors associated with 1-year mortality and determine the conditions that are associated with an unfavorable survival outcome in nonagenarians. DESIGN: Cross-sectional study SUBJECTS: Nonagenarian patients presenting with hip fractures between 2013 and 2018. METHODS: Bivariate and multivariate analyses were performed to identify variables associated with mortality, and a survival analysis was conducted to determine whether the Charlson Comorbidity Index (CCI) is associated with mortality. RESULTS: A total of 127 patients, with a mean age of 92.84 years was assessed, identifying 1-year mortality rate in 53.5% of patients. According to the bivariate analysis, requirement of postoperative vasopressor support, transfusion, decompensated heart failure and general anesthesia were associated with a higher probability of 1-year mortality after surgery. Body mass index, health status, dementia or CCI ≥ 3 were not associated with mortality. Similarly, the Kaplan-Meier survival analysis showed no difference in mortality rate of patients with CCI ≥ 3 (p = 0.282). CONCLUSION:Patients older than 90 years with hip fractures have higher mortality rates per year than younger patients. Some associations were found, but more studies are needed to reach final conclusions, which could help identify higher-risk patients and be able to implement additional measures.
Entities:
Keywords:
Aged 90 and older; Hip fractures; Mortality; Postoperative care; Risk
Authors: Kristian A Espinosa; Amparo Gómez Gélvez; Liliana P Torres; María Fernanda García; Omar R Peña Journal: Injury Date: 2018-04-13 Impact factor: 2.586
Authors: T Pareja Sierra; I Bartolomé Martín; J Rodríguez Solís; L Bárcena Goitiandia; M Torralba González de Suso; M D Morales Sanz; M Hornillos Calvo Journal: Rev Esp Cir Ortop Traumatol Date: 2017-09-06
Authors: Hannah Groff; Michael M Kheir; Jaiben George; Ibrahim Azboy; Carlos A Higuera; Javad Parvizi Journal: Hip Int Date: 2019-03-25 Impact factor: 2.135