Outcomes in Nonagenarians after Hemiarthroplasty for Femoral Neck Fracture. A Prospective Matched Cohort Study

Sanz-Reig, J.; Lizaur-Utrilla, Alejandro; Serna-Berna, R.

doi:10.5301/hip.2012.9080

Cited by 15 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this multicenter retrospective study of 327 nonagenarian individuals, Liu et al showed that the 1-year mortality after surgery was 11.6% [32]. Previous studies demonstrated that 1-year mortality in nonagenarian femoral neck patients varied from 23.3 to 47.6% [6,16,30,[33][34][35]. Although our 1-year mortality rate in the arthroplasty group was lower than those in the previously mentioned studies, it was similar to other studies [11,36].…”

Section: Discussionsupporting

confidence: 88%

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Liu

Zhang

Zhao

2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: The aging of the Chinese population is expected to lead to an increase in nonagenarians and centenarians. The mortality rate in nonagenarian hip fracture patients is equivalent to the mortality rate in the average population at 5 years after injury. It is imperative to evaluate 5-year mortality in this small but very challenging subgroup of patients to optimize patient management. The primary purpose of the current retrospective study was to compare five-year survival in patients aged over 90 years who received arthroplasty or nonoperative treatment for femoral neck fracture during a 16-year period. Methods: From January 1998 to December 2014, all consecutive nonagenarian and centenarian patients with femoral neck fracture admitted to our hospital were included in the evaluation. The primary outcome was defined as thirty-day, 1-year, 3-year, and 5-year mortality after injury. Survival analysis was performed with the Kaplan-Meier method. Using the log-rank test, stratified analyses were performed to compare differences in the overall cumulative mortality and mortality at three time points (1 year, 3 years, and 5 years) after injury and differences in survival distributions. Results: Over the 16-year study period, the arthroplasty group and the nonoperative treatment group included 33 and 53 patients, respectively. The long-term survival probability of the arthroplasty group was significantly higher than that of the nonoperative treatment group (p = 0.002). The survival time of the arthroplasty group was significantly higher than that of the nonoperative treatment group (median (P 75-P 25) = 53 (59) versus median (P 75-P 25) = 22 (52), p = 0.001). The mortality differences, except for 30-day mortality, at five time points (1, 2, 3, 4, and 5 years) between the nonoperative group and arthroplasty group were significant. The stratified analyses of overall cumulative mortality and mortality at three time points (1, 3, and 5 years) after injury demonstrated that the nonoperative treatment group had significantly higher cumulative mortality than the arthroplasty group. Conclusions: Our study demonstrates that arthroplasty is more likely to improve long-term survival in femoral neck fracture patients aged over 90 years than nonoperative treatment. It can be expected that nearly half of patients will survive more than 5 years after surgery.

show abstract

Section: Discussionsupporting

confidence: 88%

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Liu

Zhang

Zhao

2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…A report on a small number of nonagenarians who were operated on with hemiarthroplasty for femoral neck fracture described a 1-year mortality of 24% (Sanz-Reig et al. 2012), and a small retrospective study on THA performed for femoral neck fracture in octogenarians found a 30-day mortality of 3% (Kieffer et al. 2014).…”

Section: Discussionmentioning

confidence: 99%

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

Hailer¹,

Garland²,

Rogmark³

et al. 2016

Acta Orthopaedica

View full text Add to dashboard Cite

Background and purpose — Early postoperative mortality is relatively high after total hip arthroplasty (THA) that has been performed due to femoral neck fracture. However, this has rarely been investigated after adjustment for medical comorbidity and comparison with the mortality in an age-matched population. We therefore assessed early mortality in hip fracture patients treated with a THA, in the setting of a nationwide matched cohort study.Patients and methods — 24,699 patients who underwent THA due to a femoral neck fracture between 1992 and 2012 were matched with 118,518 controls. Kaplan-Meier survival analysis was used to calculate cumulative unadjusted survival, and Cox regression models were fitted to compute hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for age, sex, comorbidity, and socioeconomic background.Results — 90-day survival was 96.3% (95% CI: 96.0–96.5) for THA cases and 98.7% (95% CI: 98.6–98.8) for control individuals, giving an adjusted HR of 2.2 (95% CI: 2.0–2.4) for THA cases compared to control individuals. Comorbidity burden increased in THA cases over time, but the adjusted risk of death within 90 days did not differ statistically significantly between the time periods investigated (1992–1998, 1999–2005, and 2006–2012). A Charlson comorbidity index of 3 or more, an American Society of Anesthesiologists (ASA) grade of 3 and above, male sex, an age of 80 years and above, an income below the first quartile, and a lower level of education were all associated with an increased risk of 90-day mortality.Interpretation — The adjusted early mortality in femoral neck fracture patients who underwent THA was about double that in a matched control population. Patients with femoral neck fracture but with no substantial comorbidity and an age of less than 80 years appear to have a low risk of early death. Patients older than 80 years and those with a Charlson comorbidity index of more than 2 have a high risk of early death, and such patients would perhaps benefit from treatment strategies other than THA, but this should be investigated further.

show abstract

“…WOMAC has been used for assessing functional outcomes and quality of life in hip fracture populations before 35,36 . In the current study, it was validated in hip fracture populations for the first time.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture

Burgers¹,

Poolman

Bakel³

et al. 2015

The Journal of Bone and Joint Surgery-American Volume

View full text Add to dashboard Cite

show abstract

Outcomes in Nonagenarians after Hemiarthroplasty for Femoral Neck Fracture. A Prospective Matched Cohort Study

Cited by 15 publications

References 23 publications

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Early mortality and morbidity after total hip arthroplasty in patients with femoral neck fracture

Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture

Contact Info

Product

Resources

About