Purpose The aim of this study was to examine causes and potential risk factors for 30-day mortality after hip fracture surgery (HFS) at a high-volume tertiary-care hospital. Methods We retrospectively reviewed 467 patients who underwent HFS at our institution. Multivariate analysis was undertaken to identify potential predictors of early mortality. Results The 30-day mortality rate was 7.5 % (35/467). The most common causes of death were pneumonia (37.1 %, 13/ 35), acute coronary syndrome (31.4 %, 11/35) and sepsis (14.3 %, 5/35). Surgery after 48 hours of admission had a significantly higher 30-day mortality rate (11 % versus 4 %, p =0.006). There was a significant difference in age (p =0.034), admission source (p <0.001), preoperative haemoglobin (p < 0.001), walking ability (p =0.004), number of comorbidities (p =0.004) and pre-existing dementia (p =0.01), cardiac disease (p <0.001), chronic obstructive pulmonary disorder (COPD) (p =0.036) and renal failure (p =0.007) between the 30-day mortality group and the rest of the cohort. Surgical delay greater than 48 hours, admission source and preexisting cardiac disease were identified as the strongest predictors of 30-day mortality. Conclusion Surgical delay is an important but avoidable determinant of early mortality after HFS. Respiratory and cardiac function needs to be optimised postoperatively with early intervention in patients with signs of cardiovascular compromise or infection.

A number of studies have shown increased accuracy of pedicle screw placement in spine with the help of computer-assisted navigation. The literature is lacking in regard to functional benefit derived from this technique. The aim of this systematic review was to look at the functional outcomes following computer-assisted pedicle screw placement in spine. A 'Dialog Datastar' search was used using optimized search strategy covering the period from 1950 to July 2009; 23 papers were finally included which met our inclusion criteria. We report on a total of 1,288 patients with 5,992 pedicle screws. The comparison of neurological complications in two groups demonstrated an odds ratio of 0.25 (95% CI 0.06, 1.14) in favour of using navigation for pedicle screw insertion (p = 0.07). Comparative trials demonstrated a significant advantage in terms of accuracy of navigation over conventional pedicle screw insertion with a relative risk of 1.12 (95% CI 1.09, 1.15) (p \ 0.00001). Navigation does not show statistically significant benefit in reducing neurological complications and there was insufficient data in the literature to infer a conclusion in terms of fusion rate, pain relief and health outcome scores.

TAVR-related TP is predictable and classification by PTP and TP severity prior to TAVR allows for better risk stratification in predicting in-hospital clinical outcomes. Major TP in the presence of worsening TP is predictable and is associated with worse clinical outcomes. © 2014 Wiley Periodicals, Inc.