Does operative treatment influence mortality? A cohort analysis in nonagenarian population with hip fractures
ResumoObjective: To assess survival and factors that might influence it, in nonagenarians with hip fracture. Methods: We retrospective analyzed 134 nonagenarian patients admitted for hip fractures for a period of 9 years. A review of medical records and survival data from the National Population Register was performed. Analysis included demographic data, ASA score, surgical delay, type of treatment, mortality. Results: The mean age of the patients was 92.53 years (range 90-103 years). 35.8% of the fractures involved femoral neck and 64.2% trochanteric region. Overall mortality was 18.7% at 30 days, and 9 % at one year. Mean survival for the entire lot of patients was 683±78.1 days with a median of 339 days. The survival in men and women was 595±136.8 days and 734±94.6 days, respectively. We found that type of fracture (p=0.026), ASA score (p=0.004) were the main factors that influence survival. Kaplan-Meyer survival analysis indicated that patients with extracapsular fractures treated by internal fixation had a better survival rate (p=0.047). There was no significant differences between sexes (p = 0.102) or diagnosis (p = 0.537). Conclusion: Although nonagenarian patients have numerous comorbidities, surgery by means of internal fixation seems to be superior to a conservative approach.
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