Does operative treatment influence mortality? A cohort analysis in nonagenarian population with hip fractures

Resumo

Objective: 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.

Biografia do Autor

Alexa Ovidiu, Grigore T. Popa University of Medicine and Pharmacy Iasi
Department of Orthopedics and Traumatology, Professor doctor
Gheorghevici Teodor Stefan, Grigore T. Popa University of Medicine and Pharmacy, Iasi
Department of Orthopedics and Traumatology, PhD student
Popescu Dragos, Grigore T. Popa University of Medicine and Pharmacy, Iasi
Department of Orthopedics and Traumatology, Assistant professor
Veliceasa Bogdan, Grigore T. Popa University of Medicine and Pharmacy, Iasi
Department of Orthopedics and Traumatology, Assistant professor
Alexa Ioana Dana, Grigore T. Popa University of Medicine and Pharmacy, Iasi
Geriatrics Department, Professor doctor
Publicado
2017-06-01
Seção
Coluna - Artigo Original