Thirty-day mortality after hip fractures: has anything changed?

Giannoulis, Dionysios; Calori, G.M.; Giannoudis, Peter V.

doi:10.1007/s00590-016-1744-4

Cited by 100 publications

(72 citation statements)

References 38 publications

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“…Our population showed slightly higher mean age and slightly lower 30-day mortality rate than other previously reported studies on hip fracture populations (26,27).…”

Section: Discussioncontrasting

confidence: 56%

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Casa¹,

Pablos‐Hernández²,

González‐Ramírez³

et al. 2020

Preprint

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Background The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to validate the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale analyzed in the Comprehensive Geriatric Assessment at admission as predictors of 30-day mortality after hip fracture surgery. Methods Prospective study including 899 hip fracture patients over 65. Bed-ridden, non- surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ2, and we performed binary logistic regression for risk assessment. P < 0.05 was considered statistically significant. Results We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR = 0.986 [0.975–0.996], p = 0.010), Katz Index (OR per point = 1.254 [1.089–1.444], p = 0.002), Lawton-Brody Index (OR = 0.885 [0.788–0.992], p = 0.037), and Physical Red Cross Scale (OR = 1.483 [1.094–2.011], p = 0.011) with the 30-day mortality of patients after hip fracture surgery. We also validate the Barthel Index inflection point (0–55) (ORBI(0−55) = 2.428 [1.379–4.275], p = 0.002) and Katz Index inflection point (A-B) (ORKI(A−B) = 0.493 [0.273–0.891], p = 0.019) for the assessment of the highest risked patients. Conclusions The geriatric scores would be useful multifunctional tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.

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“…Our population showed slightly higher mean age and slightly lower 30-day mortality rate than other previously reported studies on hip fracture populations (26,27).…”

Section: Discussioncontrasting

confidence: 56%

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Casa¹,

Pablos‐Hernández²,

González‐Ramírez³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The overall 30-day mortality rate was 2.2% in this study, lower than the 3.5% to 10% reported in the UK, 17 as well as the 4.96% in a 1997 local study. 21 The lower mortality rate in this study may be attributed to advancements in surgical technique and design of prostheses.…”

Section: Mortality Ratecontrasting

confidence: 50%

“…17 In 2000, the number of hip fractures worldwide was about 1.6 million. By 2050, the projected number will reach 4.5 million, and more than 50% of osteoporotic hip fractures will occur in Asia.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of daytime and out-of-hours surgery for elderly patients with hip fracture

Chan¹,

Tang

Chow

2017

Hong Kong Med J

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“…One year mortality for intertrochanteric fractures remained about 23% after 1999 [44]. Although a steady decrease was found in the UK, 11% 30-day mortality in 2003 decreased to 8% in 2013 [45]. A combined number of improvements of care, including the implementation of fast-track care pathways, input from orthogeriatricians, quick patient medical optimization, early surgery and advanced rehabilitation protocols have contributed to this [33,45].…”

Section: Discussionmentioning

confidence: 99%

Cardiac overscreening hip fracture patients

Smeets

Wunnik

Poeze

et al. 2019

Arch Orthop Trauma Surg

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Background The aim of this study was to prospectively investigate the adherence to the American College of Cardiology (ACC) and the American Heart Association guidelines for perioperative assessment of patients with hip fracture in daily clinical practice and how this might affect outcome. Methods This prospective cohort study from Maastricht University Medical Centre included 166 hip fracture patients within a 3-year inclusion period. The preoperative cardiac screening and adherence to the ACC/AHA guideline were analyzed. Cardiac risk was classified as low, intermediate and high risk. Secondary outcome measurements were delay to surgery, perioperative complications and in-hospital, 30-day, 1-year and 2-year mortality. Results According to the ACC/AHA guideline, 87% of patients received correct preoperative cardiac screening. The most important reason for incorrect preoperative cardiac screening was overscreening (> 90%). Multivariate analysis showed that a cardiac consultation (p = 0.003) and overscreening (p = 0.02) as significant predictors for increased delay to surgery, while age, sex, previous cardiac history and preoperative mobility were not. High risk patients had in comparison with low risk patients a significantly higher relative risk ratio for in-hospital mortality (RR 6, 95% CI 2-17). Multivariate analysis showed that a previous cardiac history and increased delay to surgery were predictors for early mortality. High age and previous cardiac history were risk factors for late mortality. Conclusion Preoperative cardiac screening for hip fracture patients in adherence to the ACC/AHA guideline is associated with a diminished use of preoperative resources. Overscreening leads to greater delay to surgery, which poses a risk for perioperative complications and early mortality. Level of evidence II.

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Thirty-day mortality after hip fractures: has anything changed?

Cited by 100 publications

References 38 publications

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

Surgical outcome of daytime and out-of-hours surgery for elderly patients with hip fracture

Cardiac overscreening hip fracture patients

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