Predictors of Mortality in Patients with Femoral Neck Fracture

Purpose To identify patient and procedural factors associated with in-hospital mortality following a femoral neck fracture. Methods Records of 598 female and 259 male consecutive patients aged 29 to 108 (median, 82) years admitted between 2010 and 2014 with femoral neck fracture were retrospectively...

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Main Authors: Lisa J Major, John B North
Format: Article
Language:English
Published: SAGE Publishing 2016-08-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/1602400205
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author Lisa J Major
John B North
author_facet Lisa J Major
John B North
author_sort Lisa J Major
collection DOAJ
description Purpose To identify patient and procedural factors associated with in-hospital mortality following a femoral neck fracture. Methods Records of 598 female and 259 male consecutive patients aged 29 to 108 (median, 82) years admitted between 2010 and 2014 with femoral neck fracture were retrospectively reviewed to determine patient and procedural factors associated with in-hospital mortality. Results 73% of patients were operated on within 48 hours of admission. The in-hospital mortality was 7.5%, with 2.1% occurring preoperatively and 5.4% postoperatively. Factors associated with increased preoperative mortality included being non-ambulant prior to admission (p=0.015), residence in interim care (p=0.001) or low-level care (p=0.049), having synchronous fractures (p=0.001), and having a concurrent acute medical condition (p<0.001). Patient factors associated with increased in-hospital mortality included male gender (p=0.041), age >80 years (p=0.001), non-ambulatory status (p=0.015), residence in high-level care (p=0.031) or low-level care (p=0.018), American Society of Anesthesiologists grade 4 or 5 (p<0.001), weekend admission (p<0.001), and having an acute medical condition on admission (p<0.001). Procedural factors associated with increased in-hospital mortality included >96-hour delay to surgery from admission (p<0.001), surgery over the weekend (p=0.005), and surgical interventions other than total hip arthroplasty (p<0.05). Conclusion Identification of patient and procedural factors can guide changes in best practice to decrease mortality following a femoral neck fracture.
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spelling doaj.art-d924bd5cc0b149208b1a3e0393c5fdad2022-12-22T03:05:14ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902016-08-012410.1177/1602400205Predictors of Mortality in Patients with Femoral Neck FractureLisa J MajorJohn B NorthPurpose To identify patient and procedural factors associated with in-hospital mortality following a femoral neck fracture. Methods Records of 598 female and 259 male consecutive patients aged 29 to 108 (median, 82) years admitted between 2010 and 2014 with femoral neck fracture were retrospectively reviewed to determine patient and procedural factors associated with in-hospital mortality. Results 73% of patients were operated on within 48 hours of admission. The in-hospital mortality was 7.5%, with 2.1% occurring preoperatively and 5.4% postoperatively. Factors associated with increased preoperative mortality included being non-ambulant prior to admission (p=0.015), residence in interim care (p=0.001) or low-level care (p=0.049), having synchronous fractures (p=0.001), and having a concurrent acute medical condition (p<0.001). Patient factors associated with increased in-hospital mortality included male gender (p=0.041), age >80 years (p=0.001), non-ambulatory status (p=0.015), residence in high-level care (p=0.031) or low-level care (p=0.018), American Society of Anesthesiologists grade 4 or 5 (p<0.001), weekend admission (p<0.001), and having an acute medical condition on admission (p<0.001). Procedural factors associated with increased in-hospital mortality included >96-hour delay to surgery from admission (p<0.001), surgery over the weekend (p=0.005), and surgical interventions other than total hip arthroplasty (p<0.05). Conclusion Identification of patient and procedural factors can guide changes in best practice to decrease mortality following a femoral neck fracture.https://doi.org/10.1177/1602400205
spellingShingle Lisa J Major
John B North
Predictors of Mortality in Patients with Femoral Neck Fracture
Journal of Orthopaedic Surgery
title Predictors of Mortality in Patients with Femoral Neck Fracture
title_full Predictors of Mortality in Patients with Femoral Neck Fracture
title_fullStr Predictors of Mortality in Patients with Femoral Neck Fracture
title_full_unstemmed Predictors of Mortality in Patients with Femoral Neck Fracture
title_short Predictors of Mortality in Patients with Femoral Neck Fracture
title_sort predictors of mortality in patients with femoral neck fracture
url https://doi.org/10.1177/1602400205
work_keys_str_mv AT lisajmajor predictorsofmortalityinpatientswithfemoralneckfracture
AT johnbnorth predictorsofmortalityinpatientswithfemoralneckfracture