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Hip fracture mortality

Stefano Biggi, Andrea Camera, Riccardo Tedino, Andrea Capuzzo, Stefano Tornago
PURPOSE: To retrospectively review results and complications of our standardized surgical technique addressed exclusively to Vancouver B2 fractures. METHODS: From January 2006 to July 2016, we treated 235 consecutive patients, 47 males and 188 females, mean age at surgery of 71 ± 10 years, with periprosthetic B2 fractures. Exclusion criteria were other kind of periprosthetic fractures and other femoral fractures. The patients were assessed clinically and radiographically following our standard protocol at the last available follow-up...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Giulio Pioli, Chiara Bendini, Paolo Pignedoli, Andrea Giusti, David Marsh
A high proportion of patients with fragility fracture, mainly hip fracture, have a variable degree of comorbidity and show some degree of dependence in basic or more complex activities of daily living. Evaluating these patents following the geriatric concept of frailty, about one third of hip fracture patients may be categorised as frail with high risk of poor outcomes and prolonged length of stay, one third as not frail, and about one third with an intermediate condition. Due to the high vulnerability, combined with the hip fracture event and surgical repair procedures, a multidisciplinary approach that includes geriatric competencies becomes essential to improve short and long-term outcomes after hip fracture...
April 20, 2018: Injury
Li Fang, Jining Wu, Jing Luo, Ping Wen, Mingxia Xiong, Jinlong Cao, Xiaolan Chen, Junwei Yang
BACKGROUND: The patients with secondary hyperparathyroidism (SHPT) usually had reduced bone mineral density, which might lead to a substantial increase in osteoporosis, fracture and mortality. Although surgical intervention is effective in reducing parathyroid hormone (PTH) levels in suitable candidates refractory to medical therapy, the effect of surgery on bone mass changes still requires further evaluation. Thus, the aim of this study was to evaluate the characteristics of BMD changes after total parathyroidectomy (PTX) without autotransplantation and its associated factors...
June 15, 2018: BMC Nephrology
Takayuki Hamano
Despite the advent of cinacalcet and noncalcium-containing phosphate binders, controlling the progression of vascular calcification (VC) is still challenging. Recent reports demonstrate that carbamylation driven by high urea concentration aggravates VC, suggesting the importance of adequate dialysis in retarding its progression. Theoretically, other promising measures include the use of iron-based phosphate binders, vitamin K, and magnesium supplements, which should be investigated in future randomized controlled trials (RCTs), ideally with hard outcomes...
June 13, 2018: Seminars in Dialysis
Mary Kate Thayer, Conor P Kleweno, Vivian H Lyons, Lisa A Taitsman
Background: Elderly patients with low-energy hip fractures have high rates of morbidity and mortality, but it is not well known how often concurrent upper extremity fractures occur and how this impacts outcomes. We used the National Trauma Databank (NTDB), the largest aggregation of US trauma registry data available, to determine whether patients with concurrent upper extremity and hip fractures have worse outcomes than patients with hip fractures alone. Methods: We accessed the NTDB to identify patients aged 65 to 100 who sustained a hip fracture...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Hong Man Cho, Jae Woong Seo, Hyun Ju Lee
Purpose: This study was performed to compare the: i) 1-year survival rate of patients with hip fractures, ii) factors affecting mortality in patients with hip fractures, and iii) results of functional recovery at commissioned hospitals (CH) and veterans hospitals (VH) to characterize the quality of care provided in the Korean commissioned hospital system. Materials and Methods: The study population consisted of 183 veteran patients (84 and 99 treated at a single VH and 39 CH, respectively) who underwent hip fracture surgery between January 2010 and February 2015...
June 2018: Hip & Pelvis
Sultan Amrayev, Ussama AbuJazar, Justinas Stucinskas, Alfredas Smailys, Sarunas Tarasevicius
INTRODUCTION: Patients with hip fractures are usually treated operatively in Western Europe. However, in Mid-Asia different indications are used to decide whether this patient is suitable for operative treatment and those are related to specific traditions and rules in hospital. Thus, traditions and surgeon/patient fears seem to affect treatment choices in hip fractures and subsequent outcomes. The aim of our study was to investigate patients with hip fractures and compare outcome at 1-year follow-up in the operated and nonoperated patient groups...
March 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
M Williams, M Ng, M Ashworth
Background: Globally the incidence of fragility hip fractures is rising with increasingly elderly and co-morbid patients. These injuries are associated with a high morbidity and mortality. Aims: This clinical study's primary outcome is to establish the rate of operative inadvertent hypothermia (<36 °C) in elderly hip fracture patients (>65 years old). We also aimed to identify risk factors and outcomes in patients with inadvertent hypothermia. Patients and Methods: A single centre, retrospective study of 929 hip fracture patients managed operatively between June 2015 and July 2017 was conducted...
June 2018: Journal of Orthopaedics
Prannoy Paul, Renjit Thomas Issac
Purpose: To estimate the Impact of delay in surgery for elderly hip fractures on short term outcome measured in terms of in-hospital mortality. Methods: Retrospective study involving patients above 60 years of age with a primary diagnosis of hip fracture treated by surgery to analyze the relation between timing of surgery and in-hospital mortality. Results: There were 144 patients who met the criteria. Delayed surgery more than 48 h was associated with higher in-hospital mortality risk...
June 2018: Journal of Orthopaedics
Meng-Yun Lin, Nancy R Kressin, Michael K Paasche-Orlow, Eun Ji Kim, Lenny López, Jennifer E Rosen, Amresh D Hanchate
BACKGROUND: Multiple studies have reported that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition are lower among blacks compared with whites. OBJECTIVE: To examine if previously reported lower mortality for minorities, relative to whites, is accounted for by adjustment for do-not-resuscitate status, potentially unconfirmed admission diagnosis, and differential risk of hospitalization. RESEARCH DESIGN: Using inpatient discharge and vital status data for patients aged 18 and older in California, we examined all admissions from January 1, 2010 to June 30, 2011 for acute myocardial infarction, heart failure, pneumonia, acute stroke, gastrointestinal bleed, and hip fracture and estimated relative risk of mortality for Hispanics, non-Hispanic blacks, non-Hispanic Asians, and non-Hispanic whites...
June 5, 2018: Medical Care
Richard Saitz, Aldina Mesic, Alicia S Ventura, Michael R Winter, Timothy C Heeren, Meg M Sullivan, Alexander Y Walley, Gregory J Patts, Seville M Meli, Michael F Holick, Theresa W Kim, Kendall J Bryant, Jeffrey H Samet
BACKGROUND: People living with HIV (PLWH) commonly have low bone mineral density (BMD) (low bone mass and osteoporosis) and are at high risk for fractures. Fractures and low BMD are significant causes of morbidity and mortality, increasingly relevant as PLWH age. Alcohol use is common among PLWH and known to affect bone health. The association between alcohol use and changes in BMD among PLWH is not well understood. METHODS: We conducted a 3.5-year prospective cohort study of 250 PLWH with substance use disorder or ever injection drug use...
June 6, 2018: Alcoholism, Clinical and Experimental Research
Rafael Bielza, Asunción Mora, Francisco Zambrana, Jorge Sanjurjo, David Sanz-Rosa, Israel J Thuissard, Estefanía Arias, Marta Neira, Jorge Francisco Gómez Cerezo
BACKGROUND: Patient blood management (PBM) performs multidisciplinary strategies to optimize red blood cell (RBC) transfusion. Orthogeriatric share care models (surgeon and geriatrician manage the patient together from admission) have the goal of improving outcomes in hip fracture patients. MATERIAL AND METHODS: A prospective observational study was conducted. Patients aged ≥70 years undergoing hip fracture (HF) surgery were consecutively included. When admitted on the orthogeriatric service a PBM protocol was applied based on: perioperative antithrombotic management, intravenous iron sucrose administration and restrictive transfusion criteria...
May 30, 2018: Transfusion and Apheresis Science
Christian Kammerlander, Daniel Pfeufer, Leonard Adolf Lisitano, Stefan Mehaffey, Wolfgang Böcker, Carl Neuerburg
BACKGROUND: For elderly trauma patients, a basic goal is early mobilization, as immobilization can trigger various complications, such as venous thromboembolism, pneumonia, urinary tract infections, and pressure ulcers. Although partial weight-bearing has been shown to significantly increase mortality compared with unrestricted weight-bearing, it remains a frequent recommendation of aftercare following lower-extremity fracture fixation. METHODS: An insole force sensor was used to measure true postoperative weight-bearing by patients ≥75 years of age treated for hip fracture compared with patients 18 to 40 years of age treated for ankle fracture...
June 6, 2018: Journal of Bone and Joint Surgery. American Volume
T Rikkonen, K Poole, J Sirola, R Sund, R Honkanen, H Kröger
Our findings imply that simple functional tests can predict both hip fracture risk and excess mortality in postmenopausal women. Since the tests characterize general functional capacity (one-legged stance, squatting down, and grip strength), these simple measures should have clinical utility in the assessment of women at risk of falls and fragility fracture. INTRODUCTION: Functional impairment is associated with the risk of fall, which is the leading cause of hip fracture. We aimed to determine how clinical assessments of functional impairment predict long-term hip fracture and mortality...
June 2, 2018: Osteoporosis International
Giuseppe Bellelli, Lucio Carnevali, Maurizio Corsi, Alessandro Morandi, Antonella Zambon, Paolo Mazzola, Marianna Galeazzi, Alessandra Bonfanti, Francesca Massariello, Hajnalka Szabo, Giulia Oliveri, Justin Haas, Luca Cavalieri d'Oro, Giorgio Annoni
OBJECTIVE: Studies exploring the incidence and impact of the psychomotor subtypes of postoperative delirium (POD) on the survival of hip fracture patients are few, and results are inconsistent. We sought to assess the incidence of POD subtypes and their impact, in addition to delirium duration, on 6-month mortality in older patients after hip-fracture surgery. METHODS: This is a prospective study involving 571 individuals admitted to an Orthogeriatric Unit within a 5-year period with a diagnosis of hip fracture...
May 31, 2018: International Journal of Geriatric Psychiatry
M Agerskov, H Sørensen, J Højlund, N H Secher, N B Foss
BACKGROUND: In a frail patient group often suffering from dehydration, hip fracture is potentially fatal partly because of the blood loss and thus deteriorated circulation. An important goal for haemodynamic monitoring and resuscitation is early detection of insufficient tissue perfusion. "The peripheral perfusion index" reflects changes in peripheral perfusion and blood volume. We hypothesize that hip fracture patients are hypovolaemic with poor peripheral perfusion and accordingly respond to controlled fluid resuscitation...
May 30, 2018: Acta Anaesthesiologica Scandinavica
Chikul Mittal, Hsien Chieh Daniel Lee, Kiat Sern Goh, Cheng Kiang Adrian Lau, Leeanna Tay, Chuin Siau, Yik Hin Loh, Teck Kheng Edward Goh, Chit Lwin Sandi, Chien Earn Lee
BACKGROUND: To test a population health program which could, through the application of process redesign, implement multiple evidence-based practices across the continuum of care in a functionally integrated health delivery system and deliver highly reliable and consistent evidence-based surgical care for patients with fragility hip fractures in an acute tertiary general hospital. METHODS: The ValuedCare (VC) program was developed in three distinct phases as an ongoing collaboration between the Geisinger Health System (GHS), USA, and Changi General Hospital (CGH), Singapore, modelled after the GHS ProvenCare® Fragile Hip Fracture Program...
May 30, 2018: Journal of Orthopaedic Surgery and Research
Gillian Janes, Laura Serrant, Magi Sque
This critical review of the literature regarding the recovery experiences and healthcare needs of people under 60 following a fragility hip fracture seeks to identify the associated implications for nursing practice and inform care delivery. Forty papers were included following a structured database, citation and grey literature search and filtering of results in line with specified inclusion criteria. Hip fracture is a common, serious and complex injury and an important cause of morbidity, mortality and rising healthcare costs worldwide...
February 24, 2018: International Journal of Orthopaedic and Trauma Nursing
Sarah D Berry, Randi R Rothbaum, Douglas P Kiel, Yoojin Lee, Susan L Mitchell
Importance: The decision whether to surgically repair a hip fracture in nursing home (NH) residents with advanced dementia can be challenging. Objective: To compare outcomes, including survival, among NH residents with advanced dementia and hip fracture according to whether they underwent surgical hip fracture repair. Design, Setting, and Participants: We conducted a retrospective cohort study of 3083 NH residents with advanced dementia and hip fracture, but not enrolled in hospice care, using nationwide Medicare claims data linked with Minimum Data Set (MDS) assessments from January 1, 2008, through December 31, 2013...
May 7, 2018: JAMA Internal Medicine
S S Mørch, S Tantholdt-Hansen, N E Pedersen, C L Duus, J A Petersen, C Ø Andersen, J O Jarløv, C S Meyhoff
BACKGROUND: Post-operative sepsis considerably increases mortality, but the extent of pre-operative sepsis in hip fracture patients and its consequences are sparsely elucidated. The aim of this study was to assess the association between pre-operative sepsis and 30-day mortality after hip fracture surgery. METHODS: We conducted a retrospective analysis of data collected among 1894 patients who underwent hip fracture surgery in the Capital Region of Denmark in 2014 (NCT03201679)...
May 24, 2018: Acta Anaesthesiologica Scandinavica
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