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Factors affecting mortality after hip fracture surgery: a retrospective analysis of 578 patients

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To determine the effect of patient and surgical factors on mortality after hip fracture surgery.

Design

Retrospective study.

Setting

Level-one trauma and tertiary referral centers.

Methods

Patients were eligible if they were aged 65 years or older and had undergone surgery for a non-pathological femoral neck or intertrochanteric hip fracture between 2008 and 2011. The primary outcome was mortality: within the first year after surgery, after the first year, and survival as of the last questioning date. Of the 578 eligible patients, 399 (69 %) were women; mean age was 79 years; and mean follow-up was 17 months.

Results

Mortality during the first year was significantly more frequent in patients aged 80 years or older (67 vs. 33 %; P < 0.001). Estimated overall survival was significantly longer in women (43 vs. 37 %; P = 0.01). The type of fracture had no impact on mortality (P = 0.96). Patients with high ASA class had a significant effect on mortality (P < 0.001). Surgery timing did not affect mortality in univariate analysis (P = 0.25). The mortality rate for hemiarthroplasty was higher than osteosynthesis options (P = 0.03). The effect of the type of anesthesia on mortality was not significant (P = 0.74).

Conclusions

Older men had the highest risk of mortality within the first year. Patients with ASA ratings of class 3 or 4 need to be evaluated carefully because they appear to be at higher risk of early mortality. Osteosynthesis has a lower mortality than does arthroplasty for hip fracture and thus should be preferred if either treatment is possible.

Level of evidence

IV.

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Acknowledgments

We thank Omer Uysal, PhD, of the Bezmialem Vakif University, Department of Biostatistics, for his help with statistical analysis and Ali Tufan Pehlivan for his help with the collection of data.

Conflict of interest

All participating authors declare no conflict of interests.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Department, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey

    Kerem Bilsel, Mehmet Erdil, Mehmet Elmadag, Omer Cengiz & Cengiz Sen

  2. Orthopaedic and Traumatology Department, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

    Deniz Gulabi

Authors
  1. Kerem Bilsel
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  2. Mehmet Erdil
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  3. Deniz Gulabi
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  4. Mehmet Elmadag
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  5. Omer Cengiz
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  6. Cengiz Sen
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Correspondence to Kerem Bilsel.

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Bilsel, K., Erdil, M., Gulabi, D. et al. Factors affecting mortality after hip fracture surgery: a retrospective analysis of 578 patients. Eur J Orthop Surg Traumatol 23, 895–900 (2013). https://doi.org/10.1007/s00590-012-1104-y

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  • DOI: https://doi.org/10.1007/s00590-012-1104-y

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