Predictors of Mortality in Elderly Patients With an Intertrochanteric or a Femoral Neck Fracture

Kesmezacar, Hayrettin; Ayhan, Egemen; Ünlü, Mehmet Can; Şeker, Ali; Karaca, Saffet

doi:10.1097/ta.0b013e31819adc50

Cited by 86 publications

(89 citation statements)

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“…Although the risk began to lessen after the sixth month, almost one-third (32%) of the patients died in the first postoperative year. Many studies have reported that postfracture mortality is increased during the first year and then decreases gradually over time (1,3).…”

Section: Discussionmentioning

confidence: 99%

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Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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Background: The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. Aims:The aims of this retrospective study were: (1) to determine the factors affecting mortality of femoral neck fracture patients ≥65 years of age; (2) to compare patient mortality rates, radiological findings, and functional outcomes according to prosthesis type (unipolar or bipolar); and (3) to evaluate the persistence of inner bearing mobility of bipolar prostheses.Study Design: Retrospective comparative study. Methods:In total, 144 patients operated for hemiarthroplasty and aged ≥65 were included. We classified the patients into either unipolar or bipolar prosthesis groups. To reveal factors that affected mortality, age, sex, delay in surgery, and American Society of Anesthesiologists score were obtained from folders. Barthel Daily Living, Harris hip, and acetabular erosion scores were calculated and bipolar head movement was analysed for live patients.Results: One-year mortality was 31.94%. Age ≥75 (p=0.029), male sex (p=0.048), and delay in surgery ≥6 (p=0.004) were the patient characteristics that were related to increased mortality. There were no significant differences in sex, age, American Society of Anesthesiologists score, delay in surgery, mortality, or Barthel, Harris, acetabulum scores between the two groups. Twenty patients from each group were admitted for last follow-up. Bipolar head movement was preserved for 33.3% of patients. They were inactive patients with low Barthel and Harris scores. Conclusion:Although bipolar head movement was preserved in inactive patients, we suppose that this conferred no advantage to these patients, who could hardly walk. In this study, male patients, those aged ≥75 years, and those operated at ≥6 days had an increased risk of mortality. Also, although not significant in multivariate analysis, high American Society of Anesthesiologists score (≥3) was related to increased mortality. Considering that one of three patients died during the first postoperative year, we think that these patients should be operated as soon as possible, and expensive bipolar prostheses must be used selectively in regard to patient characteristics.

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Section: Discussionmentioning

confidence: 99%

“…Increased mortality is known to persist for several years postfracture (1), with a 1-year mortality rate of 14 to 36% (2,3). Surgery is the first choice of treatment for femoral neck fractures.…”

Section: Introductionmentioning

confidence: 99%

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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“…One year after fracture 20% of patients are not able to return to their normal social and familiar lives. Mortality is 10% in the first month, 27% in the first year and 15% superior when comparing to the same age group without fracture [2,3,6]. Common severe complications are deep venous thrombosis, pneumonia, urinary tract infection and myocardial infarction [2,3].…”

Section: Discussionmentioning

confidence: 98%

“…Mortality is 10% in the first month, 27% in the first year and 15% superior when comparing to the same age group without fracture [2,3,6]. Common severe complications are deep venous thrombosis, pneumonia, urinary tract infection and myocardial infarction [2,3]. The trauma associated with a fall, the fracture and the surgical intervention can frequently increase the frailty of an already sick patient as often elders are.…”

Section: Discussionmentioning

confidence: 99%