Acta Chir Orthop Traumatol Cech. 2022; 89(3):199-203 | DOI: 10.55095/achot2022/029

The Predictive Values of the Functional Status, Comorbidities, and the Types of Treatment on the Treatment Outcomes in Elderly Patients Following the Hip FractureOriginal papers

H. ĐOZIĆ*, M. BIŠĆEVIĆ, T. MUHAREMOVIĆ, S. ŽUJO, A. KUKULJAC, E. SKOPLJAK
Department of Orthopedic Surgery and Traumatology, General Hospital "Prim. dr. Abdulah Nakaš", Sarajevo, Bosnia and Herzegovina

PURPOSE OF THE STUDY:
The hip fracture is the leading cause of disability and deaths in elderly. If left untreated, the hip fracture results in inability to walk, and therefore the patient is dependent on the other's people help. The aim of this study was to determine the predictive values of the functional status, present comorbidities, and the types of treatment on the long-term functional status and mortality in patients with the hip fracture.

MATERIAL AND METHODS:
We analyzed the data about the patients with the hip fractures treated in the period between 01.07.2006. and 01.07.2016., with the mean follow-up period between 34.3±4.9 months. The data included radiographs, age, comorbidities, functional status on admission, functional status on discharge, and follow-ups.

RESULTS:
Female sex, increasing age, and poorer functional status upon admission, conservative treatment, trochanteric fracture, the presence of neurological or lung disease, diabetes, were all significant risk factors leading to poorer functional outcomes on the latest follow-up (p < 0.05). On the other hand, the patients who were mobile upon admission had a longer survival (38.1±3.51 months) as compared with the other patients (12.3±5.1 months; χ2=25.202, p = 0.001). Besides, the results of this study revealed that the direct, statistically significant relationship exists between the untreated internal and neurological diseases, and increased mortality and poorer functional outcomes on the latest follow-up.

CONCLUSIONS:
These results are useful for the orthopedic and trauma surgeons, who are treating these patients, the physical medicine and rehabilitation specialists, who are performing the rehabilitation of these patients, but also the health policy makers, who may promote the programmes of healthy aging (treating the diseases, maintaining fitness, etc.)

Keywords: hip fracture; comorbidity; mortality; functional status

Published: June 15, 2022  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
ĐOZIĆ H, BIŠĆEVIĆ M, MUHAREMOVIĆ T, ŽUJO S, KUKULJAC A, SKOPLJAK E. The Predictive Values of the Functional Status, Comorbidities, and the Types of Treatment on the Treatment Outcomes in Elderly Patients Following the Hip Fracture. Acta Chir Orthop Traumatol Cech. 2022;89(3):199-203. doi: 10.55095/achot2022/029. PubMed PMID: 35815486.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Bateman L, Vuppala S, Porada P, Carter W, Baijnath C, Burman K, Lee R, Hargus J. Medical management in the acute hip fracture patient: a comprehensive review for the internist. Ochsner J. 2012;12:101-110.
    2. Beaupre LA, Jones CA, Saunders LD, Johnston DW, Buckingham J, Majumdar SR. Best practices for elderly hip fracture patients. A systematic overview of the evidence. J Gen Intern Med. 2005;20:1019-1025. Go to original source... Go to PubMed...
    3. Belmont PJ Jr, Garcia EJ, Romano D, Bader JO, Nelson KJ, Schoenfeld AJ. Philip J, Belmont Jr, E Stephan J, David R, Kenneth N, Andrew S. Risk factors for complications and in-hospital mortality following hip fractures: a study using the national trauma data bank. Arch Orthop Trauma Surg. 2014;134:597-604. Go to original source... Go to PubMed...
    4. Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL, Jones MP, Rosenthal GE, Wolinsky FD. The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol. 2009;170:1290-1299. Go to original source... Go to PubMed...
    5. Bottle A, Aylin P. Mortality associated with delay in operation after hip fracture: observational study. BMJ 2006;332(7547):947-951. Go to original source... Go to PubMed...
    6. Bowers M, Parker J. Assessment of outcome after hip fracture: development of a universal assessment system for hip fractures. SICOT J. 2016;2:27. Go to original source... Go to PubMed...
    7. Bretherton P, Parker J. Early surgery for patients with a fracture of the hip decreases 30-day mortality. Bone Joint J. 2015;97(1):104-108. Go to original source... Go to PubMed...
    8. Bugeja M, Aquilina S, Farrugia C, Esposito I. Demographic study of hip fractures in the Maltese Islands. Geriatr Orthop Surg Rehabil. 2018;9:2151459318764772. Go to original source... Go to PubMed...
    9. Dailiana Z, Papakostidou I, Varitimidis S, Michalitsis G, Veloni A, Malizos K. Surgical treatment of hip fractures influencing mortalitiy. Hippokratia. 2013;17:252-255. Go to PubMed...
    10. de Miguel Artal M, Roca Chacón O, Martínez-Alonso M, Serrano Godoy M, Mas Atance J, García Gutiérrez R. Fractura de cadera en el paciente anciano: factores pronóstico de mortalidad y recuperación funcional al año [Hip fracture in the elderly patient: Prognostic factors for mortality and functional recovery at one year]. Rev Esp Geriatr Gerontol. 2018;53:247-254. Go to original source... Go to PubMed...
    11. Dong CH, Wang ZM, Zhao XL, Wang AM. The use of damage control orthopaedics to minimize negative sequelae of surgery delay in elderly comorbid patients with hip fracture. Eur Rev Med Pharmacol Sci. 2016;20:2505-2514. Go to PubMed...
    12. Fansa A, Huff S, Ebraheim N. Prediction of Mortality in Nonagenarians Following the Surgical Repair of Hip Fractures. Clin Orthop Surg. 2016;8:140-145. Go to original source... Go to PubMed...
    13. Florschutz AV, Langford JR, Haidukewych GJ, Koval KJ. Femoral neck fracture: Current Management. J Orthop Trauma. 2015;29:121-129. Go to original source... Go to PubMed...
    14. Folbert C, Hegeman H, Vermeer M, Regtuijt M, Van der Velde D, Ten Duis HJ, Slaets JP. Improved 1-year mortality in elderly patients with a hip fracture following integrated orthogeriatric treatment. Osteoporos Int. 2016;28:269-277. Go to original source... Go to PubMed...
    15. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264-272. Go to original source... Go to PubMed...
    16. Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152:380-390. Go to original source... Go to PubMed...
    17. Harvey L, Mitchell R, Brodaty H, Draper B, Close J. Differing trends in fall-related fracture and non-fracture injuries in older people with and without dementia. Arch Geront Geriatr. 2016;67:61-67. Go to original source... Go to PubMed...
    18. Chatterton D, Moores S, Ahmad S, Cattell A, Roberts J. Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Joint J. 2015;97:24-25. Go to original source... Go to PubMed...
    19. Chiarello E, Tedesco G, Cadossi M, Capra P, Terrando S, Miti A, Giannini S. Surgical prevention of femoral neck fractures in elderly osteoporotic patients. A literature review. Clin Cases Miner Bone Metab. 2016;13:42-45. Go to original source... Go to PubMed...
    20. Choi J, Kim E, Shin J, Choi Y, Kim H, Lim H. The timing of surgery and mortality in eldarly hip fractures a retrospective, multicentric cohort study. Indian J Orthop. 2014;48:599-604. Go to original source... Go to PubMed...
    21. Kanis A, Oden K, Mc Closkey E, Johansson H, Wahl H, Cooper C; IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23:2239-2256. Go to original source... Go to PubMed...
    22. Kondo A, Yamaguchi C, Fujimoto E. Relationship between admission day and timing of surgery for patients with hip fracture. Jpn J Nurs Sci. 2014;11:248-258. Go to original source... Go to PubMed...
    23. Kopp L. Edelmann K. Obruba P. Procházka B. Blšťáková K, Džupa V. Rizikové faktory úmrtí seniorů operovaných pro zlomeninu proximálního femuru [Mortality risk factors in the elderly with proximal femoral fracture treated surgically]. Acta Chir Orthop Traumatol Cech. 2009;76:41-46. Go to original source... Go to PubMed...
    24. Leavy B, Michaëlsson K, Åberg AC, Melhus H, Byberg L. The Impact of Disease and Drugs on Hip Fracture Risk. Calcif Tissue Int. 2017;100(1):1-12. Go to original source... Go to PubMed...
    25. Lee D, Jo JY, Jung JS, Kim SJ. Prognostic factors predicting early recovery of pre-fracture functional mobility in elderly patients with hip fracture. Ann Rehabil Med. 2014;38:827-835. Go to original source... Go to PubMed...
    26. Lee J, Elfar C. Timing of hip fracture surgery in the elderly. Geriatr Orthop Surg Rehabil. 2014;5:138-140. Go to original source... Go to PubMed...
    27. Lin D, Lian K, Chen Z, Wang L, Hao J, Zhang H. Emergent surgical reduction and fixation for Pipkin type I femoral fractures. Orthopedics. 2013;36:778-782. Go to original source... Go to PubMed...
    28. Mostafa MF, El-Adl W, El-Sayed MA. Operative treatment of displaced Pipkin type I and II femoral head fractures. Arch Orthop Trauma Surg. 2014;134:637-644. Go to original source... Go to PubMed...
    29. Pan P-J, Lin P-H, Tang G-J, Lan T-Y. Comparisons of mortality and rehospitalization between hip-fractured elderly with outpatient rehabilitation and those without: A STROBE-compliant article. Medicine (Baltimore). 2018;97:e0644. Go to original source... Go to PubMed...
    30. Prommik P, Kolk H, Sarap P, Puuorg E, Harak E, Kukner A, Pääsuke M, Märtson A. Estonian hip fracture data from 2009 to 2017: high rates of non-operative management and high 1-year mortality. Acta Orthop. 2019;90:159-164. Go to original source... Go to PubMed...
    31. Raaymakers EL. Fractures of the femoral neck: a rewiew and personal statement. Acta Chir Orthop Traumatol Cech. 2006;73:45-59. Go to original source... Go to PubMed...
    32. Sheehan K, Williamson L, Alexander J, Filliter C, Sobolev B, Guy P, Bearne LM, Sackley C. Prognostic factors of functional outcome after hip fracture surgery: a systematic review. Age Ageing. 2018;47:661-670. Go to original source... Go to PubMed...
    33. Shiga T, Wajima Z, Ohe Y. Is operative delay associated with increased mortality of hip fracture patients? Sistematic review, meta-analysis, and meta regression. Can J Anaesth. 2008;55:146-154. Go to original source... Go to PubMed...
    34. Tarazona-Santabalbina FJ, Belenguer-Varea Á, Rovira E, Cuesta-Peredó D. Orthogeriatric care: improving patient outcomes. Clin Interv Aging. 2016;11:843-856. Go to original source... Go to PubMed...
    35. Valizadeh M, Mazloomzadeh S, Golmohammadi S, Larijani B. Mortality after low trauma hip fracture: a prospective cohort study. BMC Musculoskelet Disord. 2012;13:143. Go to original source... Go to PubMed...

    Return to the content