In-hospital Mortality of Fragility Hip Fracture in Oldest-old patient
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Abstract
With an aging population, hip fractures in the elderly have become a growing concern. Oldest-old patients aged 80 years and above are particularly vulnerable to complications and in-hospital mortality. The objective of this study was to ascertain the prevalence of in-hospital mortality and pinpoint associated risk factors among Oldest-old patients presenting with hip fractures. Methods: This retrospective cohort study analyzed data from a hip fracture database at Maharat Nakhon Ratchasima Hospital from January 2020 to December 2021. Patients aged 80 years and above were included. Statistical analysis was performed to compare characteristics between patients who died and survived during hospitalization. Results: A total of 435 patients aged 80 years and above were included. The in-hospital mortality rate was 5.52%. Renal dysfunction was significantly associated with increased mortality. Deceased patients had significantly lower estimated glomerular filtration rates (GFR) compared to survivors (P = 0.021). Moreover, 25% of deceased patients had stage 4 or higher chronic kidney disease (CKD), significantly higher than 8.27% in survivors (P = 0.01). Postoperative pneumonia was another significant complication observed in the deceased group. Conclusion: Elderly hip fracture patients aged 80 years and above are at high risk of in-hospital mortality. Renal dysfunction (stage 4 or higher chronic kidney disease) and postoperative pneumonia were identified as significant risk factors. Proactive assessment and management of these risk factors may help reduce mortality in this vulnerable population.
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References
Chatterton BD, Moores TS, Ahmad S, Cattell A, Roberts PJ. Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Joint J. 2015; 97-B: 246–51.
Groff H, Kheir MM, George J, Azboy I, Higuera CA, Parvizi J. Causes of in-hospital mortality after hip fractures in the elderly. Hip Int. 2020 ; 30: 204–9.
Hajibandeh S, Hajibandeh S, Antoniou GA, Antoniou SA. Meta-analysis of mortality risk in octogenarians undergoing emergency general surgery operations. Surgery. 2021; 169: 1407–16.
Høydahl Ø, Edna TH, Xanthoulis A, Lydersen S, Endreseth BH. Octogenarian patients with colon cancer - postoperative morbidity and mortality are the major challenges. BMC Cancer. 2022; 22: 302.
Holt G, Smith R, Duncan K, Hutchison JD, Gregori A. Outcome after surgery for the treatment of hip fracture in the extremely elderly. J Bone Joint Surg Am. 2008; 90: 1899–905.
Luc JGY, Graham MM, Norris CM, Al Shouli S, Nijjar YS, Meyer SR. Predicting operative mortality in octogenarians for isolated coronary artery bypass grafting surgery: a retrospective study. BMC Cardiovasc Disord. 2017; 17: 275.
Semaan DB, Hafeez MS, Habib S, Abdul-Malak OM, Eslami MH. Trends and Determinants of Mortality Among Octogenarian Patients Undergoing Lower Extremity Bypass. Journal of Vascular Surgery. 2022; 75: e214–5.
Nolen SC, Evans MA, Fischer A, Corrada MM, Kawas CH, Bota DA. Cancer-Incidence, prevalence and mortality in the oldest-old. A comprehensive review. Mech Ageing Dev. 2017; 164: 113–26.
Bokshan SL, Marcaccio SE, Blood TD, Hayda RA. Factors influencing survival following hip fracture among octogenarians and nonagenarians in the United States. Injury. 2018; 49: 685–90.
Ogawa T, Schermann H, Kobayashi H, Fushimi K, Okawa A, Jinno T. Age and clinical outcomes after hip fracture surgery: do octogenarian, nonagenarian and centenarian classifications matter? Age Ageing. 2021; 50: 1952–60.
Blanco JF, da Casa C, Pablos-Hernández C, González-Ramírez A, Julián-Enríquez JM, Díaz-Álvarez A. 30-day mortality after hip fracture surgery: Influence of postoperative factors. PLoS One. 2021; 16: e0246963.
Ingstad F, Solberg LB, Nordsletten L, Thorsby PM, Hestnes I, Frihagen F. Vitamin D status and complications, readmissions, and mortality after hip fracture. Osteoporos Int. 2021; 32: 873–81.
Alzahrani K, Gandhi R, Davis A, Mahomed N. In-hospital mortality following hip fracture care in southern Ontario. Can J Surg. 2010; 53: 294–8.
End-Stage Renal Disease Affect Mortality of Hip Fractures Treated with Hemiarthroplasty in the Elderly. 33: 5–9.
Sanz-Reig J, Salvador Marín J, Pérez Alba JM, Ferrández Martínez J, Orozco Beltrán D, Martínez López JF. Risk factors for in-hospital mortality following hip fracture. Rev Esp Cir Ortop Traumatol. 2017; 61: 209–15.
Lo JC, Srinivasan S, Chandra M, Patton M, Budayr A, Liu LH, et al. Trends in mortality following hip fracture in older women. Am J Manag Care. 2015; 21: e206-214.
Ogawa T, Schermann H, Kobayashi H, Fushimi K, Okawa A, Jinno T. Age and clinical outcomes after hip fracture surgery: do octogenarian, nonagenarian and centenarian classifications matter? Age Ageing. 2021; 50: 1952–60.
Cui Z, Feng H, Meng X, Zhuang S, Liu Z, Ye K, et al. Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis. Arch Osteoporos. 2019; 14: 55.
Larpasang S, Chairungsee N, Sribunditkul S, Pluemrudee W. ประสิทธิผลของรูปแบบ Fracture Liaison Service ในการดูแลผู้ป่วยกระดูกรอบสะโพกหัก โรงพยาบาลนครพิงค์ จังหวัดเขียงใหม่. Journal of Nursing and Public Health Research. 2021; 1: 40–54.
Chatterton BD, Moores TS, Ahmad S, Cattell A, Roberts PJ. Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Joint J. 2015; 97-B(2): 246–51.
Yoon BH, Koo KH. Hip Fracture in Chronic Kidney Disease Patients: Necessity of Multidisciplinary Approach. J Korean Med Sci. 2017; 32: 1906–7.
ยศ เขียวอมร. อุบัติการณ์และปัจจัยที่เกี่ยวข้องกับอัตราตายปีแรกของผู้สูงอายุกระดูกสะโพกหักที่ผ่าตัดในโรงพยาบาลเจ้าพระยายมราช. วารสารแพทย์เขต 4-5. 2021; 40: 439–48.
