Preexisting dementia is associated with higher mortality rate in patients with femoral neck fracture

Abstract

Objective This study aimed to assess the mortality and the influence of age, Abbreviated Mental Test (AMT) scores, and American Society of Anesthesiologists (ASA) grades on patients with dementia and femoral neck fracture (FNF) at 30 days, 4 months, 1 year, and 2 years after undergoing surgery. Methods Of 1296 patients admitted with FNF, 180 had had prefracture dementia. A retrospective study of these 180 patients was carried out. The patient demographics, including age, sex, presence of diabetes mellitus (DM), lipid profile, AMT score, preoperative comorbidities, ASA grade, and incidence of postoperative delirium, were documented. Results A total of 113 patients (62.8%) died postoperatively. The mortality rate was 17.7% (20 patients) at 30 days, 54.9% (62 patients) at 4 months, 77.9% (88 patients) at 1 year, and 87.6% (99 patients) at 2 years. The mortally rate in dementia with FNF was three times higher than that in FNF without dementia and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium. Conclusions Dementia should be a principal predictive factor in mortality of FNF and should be a key determinant in all frailty scores.

Epidemiology and Management of Proximal Femoral Fractures in Italy between 2001 and 2016 in Older Adults: Analysis of the National Discharge Registry

“…The frequency of these pathologies is comparable to that observed in similar patients from Denmark, where these associated diagnoses were also identified as risk factors for 1-year mortality after hospitalization for proximal femoral fracture [ 49 ]. A relevant percentage of patients (5.8%) was affected by dementia or Alzheimer disease, conditions that are known to require special attention [ 51 ]. Osteoporosis appears to be under-diagnosed in this cohort, possibly due to a lack of interest in reporting this associated diagnosis from the perspective of the healthcare providers.…”

Girdlestone resection arthroplasty for femoral neck fractures has poorer outcomes than hemiarthroplasty in frail patients with increased risk for arthroplasty-related complications: a retrospective case study of 21 patients

“…In a large Danish population study, 1-year-mortality after hip fracture was 27% [ 12 ]. In certain patient groups mortality rates can be even higher, such as in patients with dementia [ 13 ]. In our GRA group, 1-year mortality was 71%.…”

Mechanical analysis of the femoral neck dynamic intersection system with different nail angles and clinical applications

“…In addition to being a common traumatic fracture, femoral neck fractures are associated with a high mortality rate and disability[ 24 , 25 ]. Several surgical treatment strategies are available for femoral neck fractures, including internal fixation using hollow screws, intramedullary nails, locking plates, dynamic hip screws, and joint prostheses.…”