Comparing first-year mortality rates and complications in elderly hip fracture patients who undergo surgery within 72 hours and after 72 hours in Photharam hospital,
Keywords:
Hip surgery, Mortality rate in the first year, Complication, Fragility hip fractureAbstract
The objective of this study was to compare first-year mortality rates and complications in elderly hip fracture patients who undergo surgery within 72 hours and after 72 hours.
This study was to retrospectively collect data from medical records in patients aged 50 years and over who were diagnosed with closed femoral neck fracture, close intertrochanteric fracture due to fragility fracture and were treated by surgery that was admitted to Photharam Hospital from May 2019 to May2022. The total of 125 cases were included and then divided to 41 patients who received surgery within 72 hours and 84 patients who received surgery after 72 hours. Then compare the mortality rate in the first year after surgery, complications, length of hospital stay and expenses during hospital stay. The statistics used to analyze the data consisted of descriptive statistics such as frequency distribution, percentage, mean, standard deviation, and reference statistics: independent t-test and Chi-square test.
Result: There was no significant difference in general information between two population groups. The mortality rate in the first year in patients undergoing surgery before 72 hours was less likely than patients undergoing surgery after 72 hours (p=0.059). The report of overall complications found after surgery and complications such as pressure sores, pneumonia, urinary tract infections, deep vein thrombosis was no statistically significant difference in both groups of study, however pressure sores, lung infections, and urinary tract infections were less incidence among patients who had surgery within 72 hours than those who had surgery after 72 hours. In addition, duration and cost of hospitalization was statistically significant difference (P<0.05) between the surgery group within 72 hours and the group undergoing surgery after 72 hours.
References
Forte ML, Virnig BA, Swiontkowski MF, Bhandari M, Feldman R, Eberly LE, Kane RL. Ninety-day mortality after intertrochanteric hip fracture: does provider volume matter? J Bone Joint Surg Am. 2010 Apr;92(4):799-806. doi: 10.2106/JBJS.H.01204. PMID: 20360501.
Curtis EM, Moon RJ, Harvey NC, Cooper C. The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide. Bone. 2017 Nov;104:29-38. doi: 10.1016/j.bone.2017.01.024. Epub 2017 Jan 22. PMID: 28119181; PMCID: PMC5420448.
Lefaivre KA, Macadam SA, Davidson DJ, Gandhi R, Chan H, Broekhuyse HM (2009) Length of stay, mortality, morbidity and delay to surgery in hip fractures. J Bone Joint Surg Br 91(7):922–927
Cushner F, Agnelli G, FitzGerald G, Warwick D. Complications and functional outcomes after total hip arthroplasty and total knee arthroplasty: results from the Global Orthopaedic Registry (GLORY). Am J Orthop (Belle Mead NJ). 2010 Sep;39(9 Suppl):22-8. PMID: 21290028.
Vaseenon, T., et al., Long-term mortality after osteoporotic hip fracture in Chiang Mai, Thailand. J Clin Densitom, 2010. 13(1): p. 63-67.
Dettoni F, Peveraro A, Dettoni A, Rossi R, Castoldi F, Zareh A et al (2012) Epidemiology of hip fractures in northwestern Italy: a multicentric regional study on incidence of hip fractures and their outcome at 3-year follow-up. Musculoskelet Surg 96(1):41–46
Lin C, Ou Y, Chen S, Liu Y, Lin J (2010) Comparison of artificial neural network and logistic regression models for predicting mortality in elderly patients with hip fracture. Injury 41(8):869–873
Cenzer IS, Tang V, Boscardin WJ, Smith AK, Ritchie C, Wallhagen MI et al (2016) One-year mortality after hip fracture: development and validation of a prognostic index. J Am Geriatr Soc 64(9):1863–1868
Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39(10):1157–1163
Simunovic N, Devereaux PJ, Sprague S, Guyatt GH, Schemitsch E, Debeer J, Bhandari M. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010 Oct 19;182(15):1609-16. doi: 10.1503/cmaj.092220. Epub 2010 Sep 13. PMID: 20837683; PMCID: PMC2952007.
Khan SK, Kalra S, Khanna A, Thiruvengada MM, Parker MJ. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury. 2009 Jul;40(7):692-7. doi: 10.1016/j.injury.2009.01.010. Epub 2009 May 18. PMID: 19450802.
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 Mar;55(3):146-54. doi: 10.1007/BF03016088. PMID: 18310624.
Sa-Ngasoongsong, P., Kulachote, N., Sirisreetreerux, N., Chanplakorn, P., Laohajaroensombat, S., Seeraprom, J., Suphachatwong, C., Kawinwonggowit, V., & Wajanavisit, W. (2017). Outcome of Early Hip Fracture Surgery in Elderly Patients in Ramathibodi Hospital: A Prospective Cohort Study. Ramathibodi Medical Journal, 36(1), 3–12
Stoddart J, Horne G, Devane P (2002) Influence of preoperative medical status and delay to surgery on death following a hip fracture. ANZ J Surg 72(6):405–407
Al-Ani AN, Samuelsson B, Tidermark J, Norling A, Ekström W, Cederholm T, Hedström M. 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 Jul;90(7):1436-42. doi: 10.2106/JBJS.G.00890. PMID: 18594090.
Mariconda M, Costa GG, Cerbasi S, Recano P, Aitanti E, Gambacorta M, Misasi M. The determinants of mortality and morbidity during the year following fracture of the hip: a prospective study. Bone Joint J. 2015 Mar;97-B(3):383-90. doi: 10.1302/0301-620X.97B3.34504. PMID: 25737523
Tulic G, Raspopovic E, Vujadinovic S, Sopta J, Todorovic A, Manojlovic R. Prolong pre-operative hospital stay as a predictive factor for early outcomes and mortality after geriatric hip fracture surgery: a single institution opens prospective cohort study. International orthopedics (SICOT) (2018) 42:25-31 DOI 10.1007/s00264-017-3643-7
Grimes JP, Gregory PM, Noveck H, Butler MS, Carson JL (2002) The effects of time-to-surgery on mortality and morbidity in patients following hip fracture. Am J Med 112(9):702–709
Shabat S, Heller E, Mann G, Gepstein R, Fredman B, Nyska M (2003) Economic consequences of operative delay for hip fractures in a non-profit institution. Orthopedics 26(12):1197–1199, discussion 1199
Hamilton BH, Hamilton VH, Mayo NE (1996) What are the costs of queuing for hip fracture surgery in Canada? J Health Econ 15(2):161–185
Shabat S, Heller E, Mann G, Gepstein R, Fredman B, Nyska M. Economic consequences of operative delay for hip fractures in a non-profit institution. Orthopedics. 2003;26:1197–9.
