Increased mortality after lower extremity fractures in patients &lt;65 years of age

Somersalo, Axel; Paloneva, Juha; Kautiainen, Hannu; Lönnroos, Eija; Heinänen, Mikko; Kiviranta, Ilkka

doi:10.1080/17453674.2016.1210533

Cited by 29 publications

(16 citation statements)

References 18 publications

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“…For hip fractures Standardized Mortality Rate is 2.0 for women and 3.0 for men. 5 In India, Hip fracture crude incidence above the age of 50 years was 129 per 100,000. 6 There are various studies pertaining to the early mortality of proximal femur fractures all over the world and none from subcontinent.…”

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confidence: 99%

In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

Ram

Govardhan

2019

Surg J

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Context In India, hip fracture crude incidence above the age of 50 years was 129 per 100,000. Aims The aim of this study is to analyze the in-hospital mortality following proximal femur fractures in elderly Indian population. Methods and Material The study was done in Sri Ramachandra Medical Center, Chennai, India. Patient's records were retrospectively evaluated for a period of 3 years from January 1, 2015 to January 1, 2018. The inclusion criteria were patients both male and female aged more than 65 years admitted with the diagnosis of neck of femur or intertrochanteric or subtrochanteric fractures. The exclusion criteria were patients having any associated fracture or previous hip fracture history or diagnosed primary or secondary malignancies. To evaluate any surgical delay two groups were formed. After eliminating cases based on exclusion criteria, we had 270 patients for evaluation. Statistical Analysis Used The collected data were analyzed with IBM.SPSS statistics software 23.0 Version. To describe about the data descriptive statistics frequency analysis, percentage analysis were used for categorical variables and the mean and standard deviation (SD) were used for continuous variables. To find the significant difference between the bivariate samples, Student's t-test and analysis of variance (ANOVA) were used. The p-value of 0.05 is considered as significant level. Results We had a total of 24 mortalities with 15 males and 9 females. The in-hospital mortality of patients who underwent replacement surgeries for proximal femur fractures was 14 in our study. Sixteen of the in-hospital mortality patients had low Parker's mobility score. Twenty patients had mortality when surgery was delayed more than 48 hours. Conclusions In-hospital mortality in elderly patients having proximal femur fracture increases significantly if the patient was having low-preoperative mobility status, if surgery was delayed more than 48 hours, and if patient undergoes replacement surgeries.

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confidence: 99%

In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

Ram

Govardhan

2019

Surg J

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“…While the mortality rate of older patients with a pelvic ring fracture have been reported by several authors, detailed assessment of the burden and impact of these injuries requires comparison with the mortality rates of other patient cohorts [7–13, 18]. Hill et al reported excess mortality compared to the reference population in patients with a pubic rami fracture, i.e., mortality risk remained elevated after the pubic fracture throughout the 60-month study period [8].…”

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confidence: 99%

Mortality and comorbidity after non-operatively managed, low-energy pelvic fracture in patients over age 70: a comparison with an age-matched femoral neck fracture cohort and general population

et al. 2019

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BackgroundResearch on mortality and comorbidity associated with pelvic fractures in older patients is scarce. We aimed to determine the short- and long-term mortality rates of older patients with a pelvic ring fracture compared with both an age-matched cohort of patients with a femoral neck fracture and a general population, and to investigate 30- and 60-day readmission rates after pelvic fracture.MethodsThis was a retrospective cohort study done in an emergency department of a level II/III trauma center. All patients aged over 70 years diagnosed with a pelvic or acetabular fracture between January 2010 and December 2016 in our ED were identified. Two reference populations were used: patients operated due to femoral neck fracture in our institution between 2007 and 2008 and a general population aged 70 years or more.ResultsTwo hundred nineteen patients were identified. 30- and 90-day mortality was 7.3 and 11.4%, respectively. Compared to the general population, a pelvic fracture was associated with an 8.5-fold (95% CI: 5.2–13.9) and 11.0-fold (95% CI: 5.4–22.3) 90-day mortality risk in females and males, respectively. We could not observe a difference in the risk of 90-day mortality between femoral neck fracture patients and patients with a pelvic fracture. Within 30 days, 28 (12.8%) pelvic fracture patients were readmitted for in-patient care in our hospital.ConclusionsThe mortality of older patients with pelvic ring fractures resembles that after hip fracture. Although older patients with a pelvic ring fracture rarely require operative treatment, the severity of the injury should not be considered as a class apart from hip fracture.

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“…In CFH, one OR is dedicated for orthopedic IEO every day during office hours and one OR for all emergency operations outside office hours. One OR is reserved for GLOs 4 days a week (Tuesday to Friday) during normal Finnish office hours (7.30–15 o’clock).…”

Section: Methodsmentioning

confidence: 99%

Scheduled Emergency Trauma Operation: The Green Line Orthopedic Trauma Surgery Process Of Care

Reito

Koskimaa

et al. 2018

Scand J Surg

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Background and Aims: Traditionally, patients requiring an orthopedic emergency operation were admitted to an inpatient ward to await surgery. This often led to congestion of wards and operation rooms while, for less urgent traumas, the time spent waiting for the operation often became unacceptably long. The purpose of this study was to evaluate the flow of patients coded green in a traffic light–based coding process aimed at decreasing the burden on wards and enabling a scheduled emergency operation in Central Finland Hospital. Materials and Methods: Operation urgency was divided into three categories: green (>48 h), yellow (8–48 h), and red (<8 h). Patients, who had sustained an orthopedic trauma requiring surgery, but not inpatient care (green), were assigned an operation via green line process. They were discharged until the operation, which was scheduled to take place during office hours. Results: Between January 2010 and April 2015, 1830 green line process operations and 5838 inpatient emergency operations were performed. The most common green line process diagnoses were distal radial fracture (15.4% of green line process), (postoperative) complications (7.7%), and finger fractures (4.9%). The most common inpatient emergency operation diagnosis was hip fracture (24.3%). Green line process and inpatient emergency operation patients differed in age, physical status, diagnoses, and surgical procedures. Conclusion: The system was found to be a safe and effective method of implementing orthopedic trauma care. It has the potential to release operation room time for more urgent surgery, shorten the time spent in hospital, and reduce the need to operate outside normal office hours.

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Increased mortality after lower extremity fractures in patients <65 years of age

Cited by 29 publications

References 18 publications

In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

Mortality and comorbidity after non-operatively managed, low-energy pelvic fracture in patients over age 70: a comparison with an age-matched femoral neck fracture cohort and general population

Scheduled Emergency Trauma Operation: The Green Line Orthopedic Trauma Surgery Process Of Care

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