Research Article
BibTex RIS Cite

HIP FRACTURES TREATED WITH HEMIARTHROPLASTY: INDICATORS OF MORTALITY IN PATIENTS OLDER THAN 85 YEARS

Year 2017, Volume: 18 Issue: 4, 141 - 145, 16.10.2017
https://doi.org/10.18229/kocatepetip.368682

Abstract

OBJECTIVE: The aim of this study was to determine the
preoperative risk factors of all-cause mortality in the
small but very challenging group of hip fracture patients
aged over 85 years.

MATERIALS AND METHODS: Data was gathered retrospectively
on patients aged over 85 years with a diagnosis
of hip fracture. Subsequent survival was determined.
The date of death was recorded (If present). The selected
patients were separated into 2 groups: Group1 who had
died within 1 year (n=46) and group2 who had survived
(n=83).The two groups were compared in respect of age,
gender, operating time, the time from initial trauma to
surgery, total hospitalization duration, American Society
of Anesthesiologists score, cardiac ejection fraction, type
of fracture, application of cemented or uncemented
prosthesis and number of comorbid diseases.

RESULTS: The mean age of the patients in Group 1 was
determined to be significantly higher (p=0.011). The rate
of male mortality was significantly higher (p=0.047). The
rate of mortality of patients with cemented hemiarthroplasty
was significantly higher (p=0.038). No difference
was determined between the groups in respect of mean
ASA scores (p=0.352), total hospitalization duration
(p=0.120),the time from trauma to surgery (p=0.531) or
ejection fraction (p=0.484). No significance was determined
between the groups in respect of the presence and
number of comorbid diseases.

CONCLUSIONS: The mortality rate of older male patients
aged over 85 years with cemented prosthesis applied for
hip fracture was higher. As the only parameter, which can
be modified, uncemented systems, should be selected, if
possible for the prosthesis to be used.

References

  • Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial. BMJ 2007;335(7632):1251–4.
  • Haleem S, Lutchman L, Mayahi R, Grice JH, Parker MJ. Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 2008;39(10):1157–63.
  • Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen I et al. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int 2004;15(7):567– 74
  • Hu F, Jiang C, Shen J, Tang P, Wang Y. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury 2012;43(6):676–85
  • Carpintero P, Lopez P, Leon F, Lluch M, Montero M, Aguilera C. Men with hip fractures has poorer nutritional status and survival than women: a prospective study of 165 patients. Acta Orthop 2005;76(3):331–5
  • Holvik K, Ranhoff AH, Martinsen MI, Solheim LF. Predictors of mortality in older hip fracture in patients admitted to an orthogeriatric unit in Oslo, Norway. J Aging Health 2010;22(8):1114–31.
  • Hommel A, Ulander K, Bjorkelund KB, Norrman PO, Wingstrand H, Thorngren KG. Influence of optimized treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year. Injury 2008;39(10):1164–74
  • Jamal Sepah Y, Umer M, Khan A, Ullah Khan Niazi A. Functional outcome, mortality and in-hospital complications of operative treatment in elderly with hip fractures in the developing world. Int Orthop 2010;34(3):431–5.
  • 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(9):1899-905
  • Dorr L, Faugere M, Mackel A. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14(3):231–42
  • Alegre-López J, Cordero-Guevara J, Alonso-Valdivielso JL, Fernández-Melón. Factors associated with mortality and functional disability after hip fracture: an inception cohort study. J Osteoporos Int 2005;16(7):729-36
  • Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Survival experience of aged hip fracture patients. Am J Public Health 1989;79(3):274-8
  • Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P et al. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord 2011;20(12):105.
  • Oliver CW, Burke C. Hip fractures in centenarians. Injury 2004;35(10):1025-30
  • Moran CG, Wenn RT, Sikand M, Taylor AM. Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am 2005;87(3):483-9.
  • Al-Ani AN, Samuelsson B, Tidermark J, Norling A, Ekström W, Cederholm T et al. Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients. J Bone Joint Surg Am 2008;90(7):1436-42.
  • Shiga T, Wajima Z, Ohe Y. Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression. Can J Anaesth 2008;55(3):146-54.
  • Parker MI, Pryor G, Gurusamy K. Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: A randomised controlled trial in 400 patients. J Bone Joint Surg Br 2010;92(1):116-22
  • Khan RJ, MacDowell A, Crossman P, Keene GS. Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip--a systematic review. Injury 2002;33(1):13-7
  • Anderson GH, Dias JJ, Hoskinson J, Harper WM. A randomized study of the use of bone cement with Thompson’s prosthesis in the treatment of intracapsular fractures of the femoral neck. J Bone Joint Surg 1992;74(3):132–3.
  • Muirhead-Allwood W, Hutton P, Glasgow MMS. A comparative study of cemented and uncemented Thompson prostheses. J Bone Joint Surg 1983(10); 65: 218–9.
  • Lennox IAC, McLauchlan J. Comparing the mortality and morbidity of cemented and uncemented hemiarthroplasties. Injury 1993;24(3):185–6.
  • Voskuijl T, Hageman M, Ring D. Higher Charlson Comorbidity Index Scores are associated with readmission after orthopaedic surgery. Clin Orthop Relat Res 2014;472(5):1638-44.
  • Liu Y, Peng M, Lin L, Liu X, Qin Y, Hou X. Relationship between American Society of Anesthesiologists (ASA) grade and 1-year mortality in nonagenarians undergoing hip fracture surgery. Osteoporos Int 2015;26(3):1029-33.
  • Meyer HE, Tverdal A, Falch JA, Pedersen JI. Factors associated with mortality after hip fracture. Osteoporos Int 2000;11(3):228- 32.

HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ

Year 2017, Volume: 18 Issue: 4, 141 - 145, 16.10.2017
https://doi.org/10.18229/kocatepetip.368682

Abstract

AMAÇ: Bu çalışmada ortopedik cerrahlar açısından zorlayıcı
bir popülasyon olan 85 yaş üstündeki hastalardaki
kalça kırığı olgularında, mortalite riskinin tespiti için preoperatif
risk faktörlerinin belirlenmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Kalça kırığı tanısıyla servisimize
yatırılarak tedavi ve takip edilen 85 yaş üstündeki
hastaların bilgileri hastane kayıtlarından retrospektif
olarak toplandı. Hastaların sağkalım durumları ve
hayatını kaybetmişse ölüm tarihleri tespit edildi.
Seçilmiş hastalardan hayatını kaybeden 46 hasta grup 1
olarak adlandırılırken; sağ kalan 83 hasta grup 2 olarak
adlandırıldı. Her iki grup yaş, cinsiyet, ameliyat süresi,
ameliyat olana kadar geçen süre, hastanede toplam
yatış süresi, American Society of Anesthesiologists skoru,
kardiyak ejeksiyon fraksiyonu (EF), kırık tipi, protezin
çimentolu / çimentosuz olarak uygulanması ve komorbid
faktör varlığı ile sayıları açısından karşılaştırıldı.
BULGULAR: Grup 1’deki hastaların yaş ortalaması daha
yüksekti ve istatistiksel olarak anlamlı idi (p=0.011). Erkeklerdeki
ölüm oranı daha yüksekti ve istatistiksel olarak
anlamlı idi (p=0.047). Çimentolu hemiartroplasti uygulanmış
olanlarda ölüm oranı daha yüksekti ve istatistiksel
olarak anlamlı idi (p=0,038). İki grup arasında ASA skoru
ortalamaları (p=0.352), toplam yatış süresi (p=0.120), yatıştan
ameliyat olana kadar geçen süre (p=0.531), ejeksiyon
fraksiyonları (p=0.484) açısından anlamlı fark yoktu.
SONUÇ: Yaşlı, erkek ve çimentolu protez kullanılmış olan
85 yaş üstü kalça kırıklı hastalarda ölüm oranları daha
yüksektir ve bu hastalarda takip ve tedavide daha dikkatli
olunmalı, tek modifiye edilebilir değişken olan protez
kullanımında mümkünse çimentosuz sistemler tercih
edilmelidir.

References

  • Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial. BMJ 2007;335(7632):1251–4.
  • Haleem S, Lutchman L, Mayahi R, Grice JH, Parker MJ. Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 2008;39(10):1157–63.
  • Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen I et al. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int 2004;15(7):567– 74
  • Hu F, Jiang C, Shen J, Tang P, Wang Y. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury 2012;43(6):676–85
  • Carpintero P, Lopez P, Leon F, Lluch M, Montero M, Aguilera C. Men with hip fractures has poorer nutritional status and survival than women: a prospective study of 165 patients. Acta Orthop 2005;76(3):331–5
  • Holvik K, Ranhoff AH, Martinsen MI, Solheim LF. Predictors of mortality in older hip fracture in patients admitted to an orthogeriatric unit in Oslo, Norway. J Aging Health 2010;22(8):1114–31.
  • Hommel A, Ulander K, Bjorkelund KB, Norrman PO, Wingstrand H, Thorngren KG. Influence of optimized treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year. Injury 2008;39(10):1164–74
  • Jamal Sepah Y, Umer M, Khan A, Ullah Khan Niazi A. Functional outcome, mortality and in-hospital complications of operative treatment in elderly with hip fractures in the developing world. Int Orthop 2010;34(3):431–5.
  • 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(9):1899-905
  • Dorr L, Faugere M, Mackel A. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14(3):231–42
  • Alegre-López J, Cordero-Guevara J, Alonso-Valdivielso JL, Fernández-Melón. Factors associated with mortality and functional disability after hip fracture: an inception cohort study. J Osteoporos Int 2005;16(7):729-36
  • Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Survival experience of aged hip fracture patients. Am J Public Health 1989;79(3):274-8
  • Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P et al. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet Disord 2011;20(12):105.
  • Oliver CW, Burke C. Hip fractures in centenarians. Injury 2004;35(10):1025-30
  • Moran CG, Wenn RT, Sikand M, Taylor AM. Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am 2005;87(3):483-9.
  • Al-Ani AN, Samuelsson B, Tidermark J, Norling A, Ekström W, Cederholm T et al. Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients. J Bone Joint Surg Am 2008;90(7):1436-42.
  • Shiga T, Wajima Z, Ohe Y. Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression. Can J Anaesth 2008;55(3):146-54.
  • Parker MI, Pryor G, Gurusamy K. Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: A randomised controlled trial in 400 patients. J Bone Joint Surg Br 2010;92(1):116-22
  • Khan RJ, MacDowell A, Crossman P, Keene GS. Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip--a systematic review. Injury 2002;33(1):13-7
  • Anderson GH, Dias JJ, Hoskinson J, Harper WM. A randomized study of the use of bone cement with Thompson’s prosthesis in the treatment of intracapsular fractures of the femoral neck. J Bone Joint Surg 1992;74(3):132–3.
  • Muirhead-Allwood W, Hutton P, Glasgow MMS. A comparative study of cemented and uncemented Thompson prostheses. J Bone Joint Surg 1983(10); 65: 218–9.
  • Lennox IAC, McLauchlan J. Comparing the mortality and morbidity of cemented and uncemented hemiarthroplasties. Injury 1993;24(3):185–6.
  • Voskuijl T, Hageman M, Ring D. Higher Charlson Comorbidity Index Scores are associated with readmission after orthopaedic surgery. Clin Orthop Relat Res 2014;472(5):1638-44.
  • Liu Y, Peng M, Lin L, Liu X, Qin Y, Hou X. Relationship between American Society of Anesthesiologists (ASA) grade and 1-year mortality in nonagenarians undergoing hip fracture surgery. Osteoporos Int 2015;26(3):1029-33.
  • Meyer HE, Tverdal A, Falch JA, Pedersen JI. Factors associated with mortality after hip fracture. Osteoporos Int 2000;11(3):228- 32.
There are 25 citations in total.

Details

Subjects Health Care Administration
Journal Section Articles
Authors

Mesut Tahta This is me

Tahir Öztürk This is me

Cem Özcan This is me

Tuğrul Bulut This is me

Eyüp Çağatay Zengin This is me

Muhittin Şener This is me

Publication Date October 16, 2017
Acceptance Date July 3, 2017
Published in Issue Year 2017 Volume: 18 Issue: 4

Cite

APA Tahta, M., Öztürk, T., Özcan, C., Bulut, T., et al. (2017). HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ. Kocatepe Tıp Dergisi, 18(4), 141-145. https://doi.org/10.18229/kocatepetip.368682
AMA Tahta M, Öztürk T, Özcan C, Bulut T, Zengin EÇ, Şener M. HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ. KTD. October 2017;18(4):141-145. doi:10.18229/kocatepetip.368682
Chicago Tahta, Mesut, Tahir Öztürk, Cem Özcan, Tuğrul Bulut, Eyüp Çağatay Zengin, and Muhittin Şener. “HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ”. Kocatepe Tıp Dergisi 18, no. 4 (October 2017): 141-45. https://doi.org/10.18229/kocatepetip.368682.
EndNote Tahta M, Öztürk T, Özcan C, Bulut T, Zengin EÇ, Şener M (October 1, 2017) HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ. Kocatepe Tıp Dergisi 18 4 141–145.
IEEE M. Tahta, T. Öztürk, C. Özcan, T. Bulut, E. Ç. Zengin, and M. Şener, “HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ”, KTD, vol. 18, no. 4, pp. 141–145, 2017, doi: 10.18229/kocatepetip.368682.
ISNAD Tahta, Mesut et al. “HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ”. Kocatepe Tıp Dergisi 18/4 (October 2017), 141-145. https://doi.org/10.18229/kocatepetip.368682.
JAMA Tahta M, Öztürk T, Özcan C, Bulut T, Zengin EÇ, Şener M. HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ. KTD. 2017;18:141–145.
MLA Tahta, Mesut et al. “HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ”. Kocatepe Tıp Dergisi, vol. 18, no. 4, 2017, pp. 141-5, doi:10.18229/kocatepetip.368682.
Vancouver Tahta M, Öztürk T, Özcan C, Bulut T, Zengin EÇ, Şener M. HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ. KTD. 2017;18(4):141-5.

88x31.png
Bu Dergi Creative Commons Atıf-GayriTicari-AynıLisanslaPaylaş 4.0 Uluslararası Lisansı ile lisanslanmıştır.