One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil☆

Guerra, Marcelo Teodoro Ezequiel; Viana, Roberto Deves; Feil, Liégenes; Feron, Eduardo Terra; Maboni, Jonathan; Vargas, Alfonso Soria-Galvarro

doi:10.1016/j.rboe.2016.11.006

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Original Article • Rev. bras. ortop. 52 (1) • Jan-Feb 2017 • https://doi.org/10.1016/j.rboe.2016.11.006 copy

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil^{^☆} ☆ Study conducted at the Universidade Luterana do Brasil (ULBRA), Hospital Universitário, Canoas, RS, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution.

METHOD:

The authors reviewed 213 medical records of hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013.

RESULTS:

One-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio. Anemia (p = 0.000) and dementia (p = 0.041) were significantly associated with the death group. Patients who remained hospitalized for less than 15 days and who were discharged within seven days after surgery showed increased survival.

CONCLUSION:

In the present sample of patients with hip fracture who underwent surgery, one-year mortality rate was 23.6%, and the main comorbidities associated with this outcome were anemia and dementia.

Keywords:
Hip fractures; Mortality; Elderly

Variable	Group						p^a
	Death (n = 47)		Survival (n = 152)		Total (n = 199)
	n	%	n	%	n	%
Sex
Female	34	72.3	114	75	148	74.4	0.849
Male	13	27.7	38	25	51	25.6

Age
65–75	9	19.1	54	35.5	63	31.7	0.21
76–86	20	42.6	67	44.1	87	43.7
Over 86	18	38.3	31	20.4	49	24.6

N?· of comorbidities	Group						p^a
	Death		Survival		Total
	n	%	n	%	n	%
None	1	2.1	32	21.1	33	16.6	0.4
One	13	27.7	45	29.6	58	29.1
Two	14	29.8	47	30.9	61	30.7
Three	16	34	22	14.5	38	19.1
More than three	3	6.4	6	3.9	9	4.5
Total	47	100	152	100	199	100

Comorbidities	Group						p^a
	Death (n = 47)		Survival (n = 152)		Total (n = 199)
	n	%	n	%	n	%
DM	13	27.7	35	23	48	24.1	0.560
SAH	33	70.2	92	60.5	125	62.8	0.300
Stroke	8	17	11	7.2	19	9.5	0.53
NIHD	7	14.9	18	11.8	25	12.6	0.616
IHD	5	10.6	5	3.3	10	5	0.58
Dementia	8	17	10	6.6	18	9	0.41
Depression	4	8.5	4	2.6	8	4	0.91
COPD	1	2.1	4	2.6	5	2.5	1.000
CRF	2	4.3	4	2.6	6	3	0.628
Neoplasia	2	4.3	12	7.9	14	7	0.526
Anemia	8	17	1	0.7	9	4.5	0.000
Hypothyroidism	4	8.5	3	2	7	3.5	0.55
Dyslipidemia	1	2.1	5	3.3	6	3	1.000
Smoking/alcohol use	2	4.3	6	3.9	8	4	1.000
Others	3	6.4	21	13.8	24	12.1	0.208

Variable	Response	Group						p^a
		Death (n = 47)		Survival (n = 152)		Total (n = 199)
		n	%	n	%	n	%
Fracture	Femoral neck	22	46.8	53	34.9	75	37.7	0.450
	Trochanteric	22	46.8	91	59.9	113	56.8
	Subtrochanteric	3	6.4	7	4.6	10	5
	Femoral neck + trochanteric	–	–	1	7	1	0.5
Time of fracture/surgery	Up to 7 days	5	10.6	29	19.1	34	17.1	0.352
	8–15 days	20	42.6	64	42.1	84	42.2
	Over 15 days	22	46.8	59	38.8	81	40.7
Time of fracture/admission	Up to 7 days	35	74.5	104	68.4	139	69.8	0.578
	8–15 days	9	19.1	41	27	50	25.1
	Over 15 days	3	6.4	7	4.6	10	5
Time of fracture/discharge	Up to 15 days	7	15.6	48	31.6	55	27.9	0.18
	16–30 days	23	51.1	79	52	102	51.8
	Over 30 days	15	33.3	25	16.4	40	20.3
Time of surgery/discharge	Up to 7 days	25	55.6	123	80.9	148	75.1	0.3
	8–15 days	11	24.4	15	9.9	26	13.2
	Over 15 days	9	20	14	9.2	23	11.7
Osteosynthesis	DCS	9	19.1	15	9.9	24	12.1	0.11
	DHS	14	29.8	71	46.7	85	42.7
	Cannulated screw	–	–	5	3.3	5	2.5
	PFN	1	2.1	9	5.9	10	5
	Short PFN	2	4.3	5	3.3	7	3.5
	Cemented PHR	8	17	9	5.9	17	8.5
	Cementless PHR	6	12.8	4	2.6	10	5
	Cemented THR	2	4.3	11	7.2	13	6.5
	Cementless THR	5	10.6	22	14.5	27	13.6

Complications	Group						p^a
	Death (n = 47)		Survival (n = 152)		Total (n = 199)
	n	%	n	%	n	%
UTI	3	6.4	17	11.2	20	10.1	0.418
BPN	6	12.8	11	7.2	17	8.5	0.370
SSI	4	8.5	7	4.6	11	5.5	0.464
Osteosynthesis infection	1	2.1	2	1.3	3	1.5	1.000
Osteosynthesis rupture/dislocation	1	2.1	5	3.3	6	3	1.000
Delirium	2	4.3	5	3.3	7	3.5	1.000
Sepsis without focus	8	17	3	2	11	5.5	0.001
ARF	1	2.1	3	2	4	2	1.000
Anemia	1	2.1	5	3.3	6	3	1.000
PTB	3	6.4	2	1.3	5	2	0.87
Others	3	6.4	3	2	6	3	0.145

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: mguerraz@hotmail.com (M.T. Guerra).

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One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil☆ ☆ Study conducted at the Universidade Luterana do Brasil (ULBRA), Hospital Universitário, Canoas, RS, Brazil

ABSTRACT

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSION:

One-year mortality of elderly patients with hip fracture surgically treated at a hospital in Southern Brazil^{^☆} ☆ Study conducted at the Universidade Luterana do Brasil (ULBRA), Hospital Universitário, Canoas, RS, Brazil