Mortality rate after hip hemiarthroplasty: analysis of risk factors in 299 consecutives cases |
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Authors: | F D’Angelo M Giudici M Molina G Margaria |
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Institution: | (1) Department of Orthopaedics and Trauma, Universitas Studiorum Insubriae, Viale Borri 57, I-21100 Varese, Italy;(2) Department of Statistical Analysis, Universitas Studiorum Insubriae, Varese, Italy |
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Abstract: | Abstract
The femoral neck fracture is actually the most important traumatic event in the elderly, because of its high rate and terrible
complications. We reviwed clinical records of 314 patients treated in our institution with a bipolar implant for femoral neck
fracture. At a mean follow-up of 5 years, 15 patients (4.8%) were lost to followup so data for 299 patients was studied to
identity factors associated with mortality. Ten predictor variables were examined: age, sex, waiting time for surgery, pulmonary
dysfunction, fracture etiology, and comorbidity with ischemic heart disease, and heart failure, hypertension, cerebrovascular
disease, and chronic renal failure. Cumulative mortality rate during the first 6 months was 19% (55 of 299 patients) and in
the first year it was 25% (76 of 299). At logistic regression analysis, mortality was associated with age, male gender, waiting
period for surgery and presence of neoplastic disease or pathological fracture.
Waiting for surgery was a significant factor for mortality at 6, 12 and 24 months: patients surgically treated in the first
24 hours had lower mortality than those who waited longer. The risk of mortality in the first 6 months doubled for an age
increase of 12 years, while mortality within 2 years doubled for an age increase of 9 years. Although the motality rate after
surgery for femoral neck fracture was high in the first year (25%), it dropped off in successive years to levels observed
in a healthy population. Thus, we agree with the literature that femoral fracture is a risk factor for survival only in the
first year after trauma, above all in the elderly. |
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Keywords: | Hemiarthroplasty Hip fractures Mortality |
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