Mortality after cervical hip fracture: 3002 patients followed for 6 years

Holmberg, Sara; Conradi, Patrik; Kalén, Ragnar; Thorngren, Karl–Göran

doi:10.3109/17453678608993205

Cited by 85 publications

(32 citation statements)

References 15 publications

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“…Our result are in agreement with earlier reports in which a higher mortality rate has been observed in patients admitted from institutions than in those coming from their own homes (Jensen 1984, Holmberg andThorngren 1987), and a higher rate in males than in females (Holmberg et al 1986, Holmberg andThorngren 1987).…”

Section: Discussionsupporting

confidence: 83%

“…The mortality rate of 15 percent after 3 months in our series was considerably lower than reported by Jensen and Holstein (1975) using Moore's arthroplasty (21 percent) and that reported by Stewart (1984) concerning Thompson's hemiprosthesis (36 percent). When the patients who underwent screw fixation are included, the 3-month mortality decreased to 13 percent; and this is within the range of mortalities reported by Jensen and Tondewold (1979), dealing both with trochanteric and cervical hip fractures, and Holmberg et al (1986), conceming intracapsular femoral neck fractures treated by osteosynthesis. Very low 3-month mortality rates have also been observed in selected materials, such as 7 percent among patients with cervical hip fracture managed by internal fixation and admitted from their own homes (Holmberg et al 1987).…”

Section: Discussionsupporting

confidence: 56%

“…The 5-year mortality of 59 percent was on a parity with most studies on cervical hip fractures treated by osteosynthesis. Ohman et al (1969) reported 56 percent, Holmberg et al (1986) reported a 6-year mortality of 54 percent, Nilsson et al (1988) reported 53 percent, but Beak (1972) reported 81 percent.…”

Section: Discussionmentioning

confidence: 99%

“…Alffram (1 964) found that the cumulative mortality became the same as that of the general population at 3 months and Holmberg et al (1986) at 12 months. In the material of Jensen and Tondewold (1 979) this occurred after 19 months, a figure which comes very close to our finding of 18 months.…”

Section: Discussionmentioning

confidence: 99%

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Quality of life after primary hemiarthroplasty for femoral neck fracture: 6-year follow-up of 185 patients

Jalovaara

Virkkunen

1991

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Quality of life after primary hemiarthroplasty for femoral neck fracture: 6-year follow-up of 185 patients

Jalovaara

Virkkunen

1991

Acta Orthopaedica Scandinavica

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“…Advancing age has been noted to be one such factor. 2,11,23,[27][28][29][30][31] However, other pre-injury features, such as gender, co-morbidities and environment, have frequently acted as confounding variables in these reviews. Several authors have challenged the notion that age in isolation affects the mortality rate after fracture of the hip.…”

Section: Discussionmentioning

confidence: 99%

Outcome after surgery for fracture of the hip in patients aged over 95 years

Holt¹,

Macdonald²,

Fraser

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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Despite the increase in numbers of the extreme elderly, little data is available regarding their outcome after surgery for fracture of the hip. We performed a prospective study of 50 patients aged 95 years and over who underwent this procedure. Outcome measures included morbidity, mortality, hospital stay, residential and walking status. Comparison was made with a control group of 200 consecutive patients aged less than 95 years who had a similar operation. The mortality at 28 and 120 days was higher (p = 0.005, p = 0.001) in the patients over 95 years. However, the one-year cumulative post-operative mortality was neither significantly different between the two groups (p = 0.229) nor from the standardised mortality rate for the age-matched population (p = 0.445). Predictors of mortality included the ASA grade, the number of comorbid medical conditions and active medical problems on admission. Patients over 95 were unlikely to recover their independence and at a mean follow-up of 29.3 months (12.1 to 48) 96% required permanent institutional care.More than 60% of patients with a fracture of the hip have significant coexisting medical problems at the time of presentation, 1 and a one-year mortality rate of between 14% and 47% has been reported. [2][3][4][5][6][7][8][9][10][11][12] The lifetime incidence of hip fracture in the United Kingdom is approximately 18% in women and 6% in men. 13 The annual incidence increases with age, rising from three per 100 women aged between 65 and 74 to 12.6 per 100 aged 85 or older. 14,15 At present there are some 250 000 people over the age of 95 residing in the United Kingdom and it is predicted that this number will increase dramatically over the next decade. 16Previous studies have associated advanced age with increased mortality after hip fracture, [17][18][19][20][21][22] and increasing age has been linked with poorer functional recovery, diminished walking ability and increased post-operative complications. 6,8,17,18,21,22 Extremely old patients represent a small but challenging subpopulation of those with fractures of the hip, but there is little published in the way of specific outcome. Patients and MethodsPatients aged 95 years and older presenting with a fracture of the hip were identified prospectively on presentation from the start of 2000 and were followed up until September 2004 either until their death or to the conclusion of the study. Follow-up information was collected from medical, general practitioner (GP) and physiotherapy/occupational therapy records and, where possible, the patients were also contacted. If a patient was unable to give the appropriate information, a family member, carer or GP was then interviewed. The data were compared that from a control cohort consisting of 200 consecutive individuals under the age of 95 who underwent similar surgery during the period of study. The control group was followed up for a period of 12 months.All fracture types were included. In the control group four patients (2%) sustained fractures which were subsequently h...

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