$Outcome after osteosynthesis of hip fractures in nonagenarians$
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Outcome after osteosynthesis of hip fractures in nonagenarians

Kevin de Leur,1 Jos P A M Vroemen,1 Dagmar I Vos,1 Leon Elmans,2 Lijckle van der Laan1 1Department of Surgery, 2Orthopedics, Amphia Hospital, Breda, The Netherlands Background: Hip fractures in the elderly population are associated with high morbidity and mortality. However, there is still a lack o...

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Autores principales:	de Leur K, Vroemen JP, Vos DI, Elmans L, van der Laan L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	hip fracture osteosynthesis very elderly people mortality loss of independency Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/2a914c13dfe34d78964e4834e8f2556d
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spelling	oai:doaj.org-article:2a914c13dfe34d78964e4834e8f2556d2021-12-02T01:15:36ZOutcome after osteosynthesis of hip fractures in nonagenarians1178-1998https://doaj.org/article/2a914c13dfe34d78964e4834e8f2556d2013-12-01T00:00:00Zhttps://www.dovepress.com/outcome-after-osteosynthesis-of-hip-fractures-in-nonagenarians-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Kevin de Leur,1 Jos P A M Vroemen,1 Dagmar I Vos,1 Leon Elmans,2 Lijckle van der Laan1 1Department of Surgery, 2Orthopedics, Amphia Hospital, Breda, The Netherlands Background: Hip fractures in the elderly population are associated with high morbidity and mortality. However, there is still a lack of information on mortality and loss of independence in extremely elderly people with a hip fracture. Objective: To study functional outcomes and mortality after osteosynthesis of hip fractures in very old patients in our clinic. Patients and methods: Hospital charts of all patients over 90 years old who were operated for a hip fracture between January 2007 and December 2011 were reviewed. Outcome measures were mortality, preoperative and postoperative mobility, and loss of independence. Results: A total of 149 patients were included; 132 (89%) women, median age 93.5±2.45 years. Thirty-six (24%) patients were classified as American Society of Anesthesiologists (ASA) grade 2, 104 (70%) as ASA grade 3, and nine (6%) as ASA grade 4. The Charlson comorbidity index (CCI) score was 2 or less in 115 (77%) patients and 34 (23%) patients scored 3 or more points. Short-term survival was 91% and 77% at 30 days and 3 months, respectively. Long-term survival was 64%, 42%, and 18% at 1, 3, and 5 years after surgery, respectively. Survival was significantly better in patients with lower ASA scores (P=0.005). No significant difference in survival was measured between patients according to CCI score (P=0.13). Fifty-one percent of patients had to be accommodated in an institution with more care following treatment, and 57% were less mobile after osteosynthesis of a hip fracture. Conclusion: Our study shows that short-term mortality rates in very elderly patients with a hip fracture are high and there is no clear predictive value for mortality. ASA classification is the best predictive value for overall mortality. A large proportion of these patients lost their independence after osteosynthesis of a hip fracture. Keywords: hip fracture, osteosynthesis, very elderly people, mortality, loss of independencede Leur KVroemen JPVos DIElmans Lvan der Laan LDove Medical Pressarticlehip fractureosteosynthesisvery elderly peoplemortalityloss of independencyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 41-49 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	hip fracture osteosynthesis very elderly people mortality loss of independency Geriatrics RC952-954.6
spellingShingle	hip fracture osteosynthesis very elderly people mortality loss of independency Geriatrics RC952-954.6 de Leur K Vroemen JP Vos DI Elmans L van der Laan L Outcome after osteosynthesis of hip fractures in nonagenarians
description	Kevin de Leur,1 Jos P A M Vroemen,1 Dagmar I Vos,1 Leon Elmans,2 Lijckle van der Laan1 1Department of Surgery, 2Orthopedics, Amphia Hospital, Breda, The Netherlands Background: Hip fractures in the elderly population are associated with high morbidity and mortality. However, there is still a lack of information on mortality and loss of independence in extremely elderly people with a hip fracture. Objective: To study functional outcomes and mortality after osteosynthesis of hip fractures in very old patients in our clinic. Patients and methods: Hospital charts of all patients over 90 years old who were operated for a hip fracture between January 2007 and December 2011 were reviewed. Outcome measures were mortality, preoperative and postoperative mobility, and loss of independence. Results: A total of 149 patients were included; 132 (89%) women, median age 93.5±2.45 years. Thirty-six (24%) patients were classified as American Society of Anesthesiologists (ASA) grade 2, 104 (70%) as ASA grade 3, and nine (6%) as ASA grade 4. The Charlson comorbidity index (CCI) score was 2 or less in 115 (77%) patients and 34 (23%) patients scored 3 or more points. Short-term survival was 91% and 77% at 30 days and 3 months, respectively. Long-term survival was 64%, 42%, and 18% at 1, 3, and 5 years after surgery, respectively. Survival was significantly better in patients with lower ASA scores (P=0.005). No significant difference in survival was measured between patients according to CCI score (P=0.13). Fifty-one percent of patients had to be accommodated in an institution with more care following treatment, and 57% were less mobile after osteosynthesis of a hip fracture. Conclusion: Our study shows that short-term mortality rates in very elderly patients with a hip fracture are high and there is no clear predictive value for mortality. ASA classification is the best predictive value for overall mortality. A large proportion of these patients lost their independence after osteosynthesis of a hip fracture. Keywords: hip fracture, osteosynthesis, very elderly people, mortality, loss of independence
format	article
author	de Leur K Vroemen JP Vos DI Elmans L van der Laan L
author_facet	de Leur K Vroemen JP Vos DI Elmans L van der Laan L
author_sort	de Leur K
title	Outcome after osteosynthesis of hip fractures in nonagenarians
title_short	Outcome after osteosynthesis of hip fractures in nonagenarians
title_full	Outcome after osteosynthesis of hip fractures in nonagenarians
title_fullStr	Outcome after osteosynthesis of hip fractures in nonagenarians
title_full_unstemmed	Outcome after osteosynthesis of hip fractures in nonagenarians
title_sort	outcome after osteosynthesis of hip fractures in nonagenarians
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/2a914c13dfe34d78964e4834e8f2556d
work_keys_str_mv	AT deleurk outcomeafterosteosynthesisofhipfracturesinnonagenarians AT vroemenjp outcomeafterosteosynthesisofhipfracturesinnonagenarians AT vosdi outcomeafterosteosynthesisofhipfracturesinnonagenarians AT elmansl outcomeafterosteosynthesisofhipfracturesinnonagenarians AT vanderlaanl outcomeafterosteosynthesisofhipfracturesinnonagenarians
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Outcome after osteosynthesis of hip fractures in nonagenarians

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