A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year

Background: Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence...

Full description

Bibliographic Details
Main Authors: T S Channappa, Manju Jayaram, H B Shivakumar, C L Karan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Orthopaedic Diseases and Traumatology
Subjects:
Online Access:http://www.jodt.org/article.asp?issn=2665-9352;year=2023;volume=6;issue=1;spage=101;epage=105;aulast=Channappa
_version_ 1797954810792640512
author T S Channappa
Manju Jayaram
H B Shivakumar
C L Karan
author_facet T S Channappa
Manju Jayaram
H B Shivakumar
C L Karan
author_sort T S Channappa
collection DOAJ
description Background: Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence of morbidity and mortality after hip fractures was evaluated in this study. Methodology: We included 102 patients who were divided into two groups; 54 patients with fracture neck treated by hemiarthroplasty as arthroplasty group, and 48 with intertrochanteric fracture treated by internal fixation with proximal femoral nail or with dynamic hip screw as internal fixation (IF) group were followed up for 1 year. The preexisting medical comorbidities, intraoperative findings, and postoperative complications were documented. The final functional results were evaluated using Merle d'Aubigne score at the end of 1 year. Results: This is a descriptive cohort study from the local population. The mean age was 74.5 years. We noted a total mortality of 17.6%. Diabetes mellitus and anemia were the most common comorbidities. Binary logistic regression analysis was performed to predict the survival status among the study patients. We found that male patients with anemia to be most associated with mortality. Excellent results were noted in 39% of cases of arthroplasty and 60% of cases of IF. Morbidity experienced was greater in extracapsular fracture type, who were less mobile during the postoperative period. Conclusion: Hip fractures are on a rising trend in the elderly population, especially in the Indian subcontinent. Mortality and morbidity in elderly patients in the 1st year are significant. Age and preexisting comorbidities contribute to morbidity. Morbidity leads to loss of independence and requirement of social support. The goal of treatment in fractures of the hip must be the restoration of the patient to their preinjury status at the earliest possible time.
first_indexed 2024-04-10T23:23:21Z
format Article
id doaj.art-a8894cc1be0a4c03b45d543470b91be9
institution Directory Open Access Journal
issn 2665-9352
2665-9360
language English
last_indexed 2024-04-10T23:23:21Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Orthopaedic Diseases and Traumatology
spelling doaj.art-a8894cc1be0a4c03b45d543470b91be92023-01-12T13:23:14ZengWolters Kluwer Medknow PublicationsJournal of Orthopaedic Diseases and Traumatology2665-93522665-93602023-01-016110110510.4103/jodp.jodp_75_22A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st YearT S ChannappaManju JayaramH B ShivakumarC L KaranBackground: Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence of morbidity and mortality after hip fractures was evaluated in this study. Methodology: We included 102 patients who were divided into two groups; 54 patients with fracture neck treated by hemiarthroplasty as arthroplasty group, and 48 with intertrochanteric fracture treated by internal fixation with proximal femoral nail or with dynamic hip screw as internal fixation (IF) group were followed up for 1 year. The preexisting medical comorbidities, intraoperative findings, and postoperative complications were documented. The final functional results were evaluated using Merle d'Aubigne score at the end of 1 year. Results: This is a descriptive cohort study from the local population. The mean age was 74.5 years. We noted a total mortality of 17.6%. Diabetes mellitus and anemia were the most common comorbidities. Binary logistic regression analysis was performed to predict the survival status among the study patients. We found that male patients with anemia to be most associated with mortality. Excellent results were noted in 39% of cases of arthroplasty and 60% of cases of IF. Morbidity experienced was greater in extracapsular fracture type, who were less mobile during the postoperative period. Conclusion: Hip fractures are on a rising trend in the elderly population, especially in the Indian subcontinent. Mortality and morbidity in elderly patients in the 1st year are significant. Age and preexisting comorbidities contribute to morbidity. Morbidity leads to loss of independence and requirement of social support. The goal of treatment in fractures of the hip must be the restoration of the patient to their preinjury status at the earliest possible time.http://www.jodt.org/article.asp?issn=2665-9352;year=2023;volume=6;issue=1;spage=101;epage=105;aulast=Channappacomorbiditieship fracturesmerle d'aubigne score
spellingShingle T S Channappa
Manju Jayaram
H B Shivakumar
C L Karan
A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
Journal of Orthopaedic Diseases and Traumatology
comorbidities
hip fractures
merle d'aubigne score
title A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
title_full A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
title_fullStr A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
title_full_unstemmed A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
title_short A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year
title_sort study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st year
topic comorbidities
hip fractures
merle d'aubigne score
url http://www.jodt.org/article.asp?issn=2665-9352;year=2023;volume=6;issue=1;spage=101;epage=105;aulast=Channappa
work_keys_str_mv AT tschannappa astudyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT manjujayaram astudyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT hbshivakumar astudyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT clkaran astudyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT tschannappa studyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT manjujayaram studyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT hbshivakumar studyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear
AT clkaran studyofmorbidityandmortalityofsurgicallymanagedhipfracturesinelderlypatientsinthe1styear