Factors which influence postoperative mortality after hip fracture

Abstract

Background/Aim. One of the most significant predictors of mortality after hip fractures is cognitive impairment (dementia). The aim of this study was to report the results of a prospective study of the influence of some factors on sixmonth mortality in elderly patients with hip fractures. Method. The elderly patients with hip fracture were assessed on admission to the hospital using the measures of cognitive function, the mobility before the fracture, and physical comorbidity, the type of fracture and the place of the injury. Six months later, we checked how many of them were still alive. Results. We performed univariate and multivariate analyses in 132 patients and found that the most significant predictors of six-month mortality were dementia, comorbidity, and prefacture mobility. Conclusions. A comprehensive physical and mental health assessment of an elderly patient after hip fracture could predict mortality. A good examination of cognitive functioning could be very useful in choosing the optimal treatment for this type of patients.

Uvod/Cilj. U radu su prikazani rezultati prospektivne studije o uticaju nekih faktora na smrtnost starijih bolesnika sa prelomom kuka. Posebno je analiziran uticaj demencije na šestomesečni mortalitet. Metode. Prilikom prijema u bolnicu svakom bolesniku sa prelomom kuka urađena je procena mentalnog statusa (kognicije), procena mobilnosti pre preloma, procena stanja opšteg zdravlja i prisustvo pratećih bolesti, tip preloma, kao i mesto povređivanja. Praćen je šestomesečni mortalitet bolesnika i urađena je univarijantna i multivarijantna regresiona analiza dobijenih rezultata. Rezultati. Obradom podataka kod 132 bolesnika utvrđeni su kao najznačajniji prediktori šestomesečnog mortaliteta: demencija, komorbiditet (prateće bolesti) i mobilnost pre preloma. Zaključak. Celovita procena fizičkog i mentalnog zdravlja je najvažniji činilac u predviđanju ishoda lečenja starih bolesnika sa prelomom kuka. Dobra procena u vezi sa kognitivnim poremećajima, a pre svega demencijom, može biti veoma korisna u odabiru odgovarajućeg načina lečenja bolesnika sa prelomom kuka.