Perioperative mortality for patients with a hip fracture |
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| Affiliation: | 1. Department of Anaesthetics, North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, United Kingdom;2. Department of Trauma & Orthopaedics, North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, United Kingdom;1. Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany;2. Department of Knee and Shoulder Surgery, Sports Traumatology, Asklepios Clinic St. Georg, Hamburg, Germany;3. "Fracture Committee" of the German Knee Society, Germany;1. Department of Orthopaedic Surgery, The Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia;2. University of Queensland School of Medicine, Brisbane, QLD, Australia;3. Orthopaedic Research Centre of Australia, Brisbane, QLD, Australia;4. Paley Institute, St. Mary’s Hospital, West Palm Beach, FL, USA;5. Department of Orthopaedic Surgery, Medical School of Istanbul, University of Istanbul, Istanbul, Turkey;6. Wellstar Health System, OrthoAtlanta private practice group, Atlanta, GA, USA;7. Department of Orthopaedic Trauma, St. Vincent’s Hospital, Indianapolis, IN, USA;8. University of Texas Health Science Center, San Antonio, Texas, USA;9. Musculoskeletal Research Unit, Central Queensland University, Rockhampton, QLD, Australia;10. International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital, Baltimore, MD, USA;1. Hip Injury Department, Henan Provincial Luoyang Orthopedic Hospital, Luoyang City, China;2. Department of Orthopedic Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, USA;1. Department of Orthopaedic Surgery, Gyeongsang National University, College of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do, 51472, Republic of Korea;2. Department of Orthopedic Surgey, Samsung Changwon hospital, Sungkyunkwan University, school of medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do, 51353, Republic of Korea;1. BG-Klinik Ludwigshafen, MINTOS Research Group, Clinic for Trauma Surgery and Orthopaedics, Trauma Surgery Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany;2. Siemens Healthcare GmbH, Advanced Therapies, Surgery, Research & Development, HC AT SU R&D NT MCA, Siemensstr. 1, 91301 Forchheim, Germany |
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| Abstract: | IntroductionStudies on mortality following hip fracture surgery have hitherto focused on the 30 day to 1 year period and beyond. This study focuses on the immediate perioperative period. It examines mortality rates, patient characteristics, operative details and post-operative complications.Patients and methodsA retrospective study of a hip fracture database in a large District General Hospital in the United Kingdom, from 1986 to 2015. A dataset of 9393 patients was identified, including patients undergoing surgery for curative and palliative purposes, over fifteen years of age and with no upper age limit imposed. It compared patients who survived the first 48 h from start of surgery with those who died within this perioperative period.Results9393 patients were treated surgically and included within this study, with a mean age of 80.13 and consisting of 7130 female and 2263 male patients. The all cause mortality within 48 h from start of surgery was 0.8% (72 patients). Increased risk of perioperative mortality was associated with increasing age, ASA grade 3 and above, in-hospital falls, impaired mobility prior to the fall and a reduced mental test score on admission. For the patient with a perioperative death, the most common circumstances identified in this study involved being found dead in bed by attending staff within 48 h of surgery.DiscussionThere has been significant attention paid to the optimization of patient management leading up to hip fracture surgery and its attendant impact on medium and longer term survival. The information from this study may be used to identify patients most at risk of death in the 48 h after surgery. The importance of this dataset is that it provides large numbers, which are needed in order to look for associations, given the low 48 h mortality rate found.ConclusionWe are unable to highlight any correctable or alterable factors associated with mortality. Further studies with detailed collection of data on a national scale may be needed to assess the impact of levels of postoperative care for hip fracture patients and perioperative mortality. |
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| Keywords: | Hip fracture Mortality Early postoperative mortality Perioperative period Postoperative care |
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