Early Mortality After Hip Fracture

Moran, C.G.; Wenn, R.; Sikand, Manoj; Taylor, Andrew M.

doi:10.2106/jbjs.d.01796

Cited by 442 publications

(167 citation statements)

References 7 publications

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“…44 Delayed time to surgical fixation for hip fractures increases morbidity and mortality and decreases future function. 15,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]46 Our study confirmed this. Increasing time to surgery led to an increasing number of complications (P ¼ .0492) and a trend toward higher mortality (P ¼ .091).…”

Section: Discussionsupporting

confidence: 87%

“…[25][26][27] Many authors have therefore focused on factors that may decrease complications and improve mortality following hip fracture surgery. [15][16][17][18][19] Time to surgery, in particular, has attracted considerable attention. Zuckerman et al found that an operative delay of more than 2 calendar days doubled the 1-year mortality risk.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13][14][15] Poor outcomes may be predicted by patient comorbidities, surgical timing, and surgical volume. 7,[15][16][17][18][19][20][21][22][23][24][25][26][27] The effect of surgical time of day on hip fracture outcome is less clear.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation

Switzer

Bennett

Wright

et al. 2013

Geriatr Orthop Surg Rehabil

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Background: Due to the need for medical optimization and congested operating room schedules, surgical repair is often performed at night. Studies have shown that work done at night increases complications. The primary aim of our study is to compare the rates of complications and 30-day mortality between 2 surgical times of day, daytime group (DTG, 07:00-15:59) and nighttime group (NTG,. Methods: Retrospective chart review from 2005 through 2010. Setting: Level 1 Trauma Center. Participants: 1443 patients with hip fracture, age 50 years with isolated injury and surgical treatment of the fracture. Main Outcomes and Measures: Thirty-day mortality and complications: myocardial infarction, cardiac event, stroke, central nervous system event, pneumonia, urinary tract infection, postoperative wound infection, and bleeding requiring transfusion of 3 or more red blood cell units. Results: A total of 859 patients met the inclusion criteria; 668 patients in the DTG and 191 patients in the NTG. The 30-day mortality was 7.8%. The complication rate was 28%. No difference was found in 30-day mortality or complication rate based on the time of day the surgery was performed (P ¼ 1.0 and P ¼ .92, respectively). This remained unchanged when controlling for health status and surgical complexity. Age (odds ratio ¼ 1.03/year), Charlson Comorbidity Index (CCI; odds ratio ¼ 1.21), and American Society of Anesthesiologists (ASA; odds ratio ¼ 1.85) score were predictive of adverse outcomes. Conclusion: Surgical time of day did not affect 30-day mortality or total number of complications. Age, ASA score, and CCI were associated with adverse outcomes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation

Switzer

Bennett

Wright

et al. 2013

Geriatr Orthop Surg Rehabil

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“…Fractures of the hip and vertebral body are the most commonly associated injuries with increased post-injury mortality. [9][10][11][12][13][14][15] Mortality after vertebral fractures has been reported to range between 16% and 60% greater than an unaffected population. [15][16][17] In a previous publication, these two morbidity scores provided a control for the medical comorbidities of patients with osteoporosis who sustained vertebral compression fractures treated either surgically or conservatively.…”

Section: Introductionmentioning

confidence: 99%

Mortality Prediction in a Vertebral Compression Fracture Population: the ASA Physical Status Score versus the Charlson Comorbidity Index

2015

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Background Morbidity and mortality scores are useful to control for medical comorbidities in study populations where either effects of an illness or benefits of a treatment are examined. Our study examined if a direct relationship existed between the American Society of Anesthesiologists Physical Status (ASA) score and the Charlson Comorbidity Index (CCI) in an osteoporosis population where patients had sustained a vertebral compression fracture.

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“…It is estimated that about 60% of women and 30% of men at the age of 60 or above suffer from osteoporosis. Twelve months after a hip fracture, there is a 24% mortality rate (Giversen, 2007;Jiang et al, 2005;Moran, Wenn, Sikand, & Taylor, 2005;Rosell & Parker, 2003); 26% of those with a hip fracture remain in nursing homes (Rosell & Parker, 2003;Wehren & Magaziner, 2003) and the remaining 50% never regain independent living (Sernbo & Johnell, 1993;Wehren & Magaziner, 2003). In Australia, one in three men and one in two women are at risk of osteoporosis.…”

Section: Bone Anatomy and Osteoporosismentioning

confidence: 99%

Ultrasound Transit Time Spectroscopy in Complex Media - Applications and Relationship with Phase Interference

Qahtani¹,

Mueed²

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Osteoporosis is a common disease affecting a large proportion of the human population worldwide. It is described as a bone density and structure deterioration leading to a bone fracture risk. The World Health Organisation (WHO) recognises osteoporosis as one of the most health issue since it is asymptomatic. Globally, two third of women and one third of men over 50 years is diagnosed with osteoporosis.One million in Australia alone have osteoporosis and over six million is considered with low bone mass which cost the budget healthcare sector about 2.75 $ billion dollars a year. The expectation rate of population affected by osteoporosis is assumed to significantly increase with continuous increase of aging population. Therefore, an urgent powerful and precise technique for early detection of bone loss is required.There are several techniques in the market available but the Dual Energy Absorptiometry (DXA) is the only one authorised for this regard by the WHO.However, the controversy is that DXA can only measure the bone density but not yet the bone microarchitecture which is an important factor for the assessment of bone.Quantitative ultrasound (QUS), in terms of broadband ultrasound attenuation (BUA) and speed of sound (SOS), is an alternative method that has been investigated by numerous studies confirming that it is a reliable technique for the assessment of bone and predicting fracture risk. Yet, sufficient knowledge about the propagation of ultrasound waves through complex structure such as cancellous bone is not attained which affects the ability of accurate determination of bone mass and structure.A new proposed hypothesis is that phase interference is the leading attenuation mechanism in complex composite such as cancellous bone due to inhomogeneity transit time of the sonic rays. It also proposed that the propagation of ultrasound wave can be approximated as parallel sonic rays; each has a transit time determined by the proportion of bone (solid) and marrow (liquid) it travels through. Thus, a transit time spectrum (TTS) can be defined describing the proportion of sonic rays of the same transit times. Therefore, this thesis will illustrate a development and validation of an ultrasound transit time model of complex structure such as cancellous bone and identify its relation with phase interference. This study will further explore possible ULTRASOUND TRANSIT TIME SPECTROSCOPY IN COMPLEX MEDIA -APPLICATIONS AND RELATIONSHIP WITH PHASE INTERFERENCE IV applications of the TTS to enhance the effectiveness of ultrasound as a reliable assessment tool for bone.In particular, an examination of the phase interference, created by the variation in transit time, being the main attenuation factor in complex structure among other factors for instance absorption and structure-scattering was performed. Amore fundamental concept of phase interference was investigated showing that it has both temporal and spatial phase interference. The temporal phase interference depends on the pulse length and the transit time di...

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Early Mortality After Hip Fracture

Cited by 442 publications

References 7 publications

Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation

Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation

Mortality Prediction in a Vertebral Compression Fracture Population: the ASA Physical Status Score versus the Charlson Comorbidity Index

Ultrasound Transit Time Spectroscopy in Complex Media - Applications and Relationship with Phase Interference

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