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Hip fracture mortality

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https://www.readbyqxmd.com/read/29052793/comparison-of-fracture-risk-assessment-tools-in-older-men-without-prior-hip-or-spine-fracture-the-mros-study
#1
Margaret L Gourlay, Victor S Ritter, Jason P Fine, Robert A Overman, John T Schousboe, Peggy M Cawthon, Eric S Orwoll, Tuan V Nguyen, Nancy E Lane, Steven R Cummings, Deborah M Kado, Jodi A Lapidus, Susan J Diem, Kristine E Ensrud
Femoral neck bone mineral density (BMD), age plus femoral neck BMD T score, and three externally generated fracture risk tools had similar accuracy to identify older men who developed osteoporotic fractures. Risk tools with femoral neck BMD performed better than those without BMD. The externally developed risk tools were poorly calibrated. INTRODUCTION: We compared the performance of fracture risk assessment tools in older men, accounting for competing risks including mortality. METHODS: A comparative ROC curve analysis assessed the ability of the QFracture, FRAX® and Garvan fracture risk tools, and femoral neck bone mineral density (BMD) T score with or without age to identify incident fracture in community-dwelling men aged 65 years or older (N = 4994) without hip or clinical vertebral fracture or antifracture treatment at baseline...
October 20, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29048688/is-endoprosthetic-replacement-of-the-proximal-femur-appropriate-in-the-comorbid-patient
#2
Arun Khajuria, Jonathon Ward, George Cooper, Jonathon Stevenson, Michael Parry, Lee Jeys
INTRODUCTION: Patients with failed hip arthroplasty requiring extensive femoral reconstruction often present with a multitude of comorbidities. Many treatment options limit initial mobilisation relying on bone graft incorporation. The use of endoprosthetic replacement (EPR), despite often being a "last resort", offers an expeditious solution with early mobilisation that is crucial in the comorbid individual. Many perceive that the surgical insult of EPR is associated with an increased mortality...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29046102/hip-fracture-surgery-in-mixed-use-emergency-theatres-is-the-infection-risk-increased-a-retrospective-matched-cohort-study
#3
S K Agarwal, A A Khan, M Solan, M Lemon
Introduction The National Institute of Health and Care Excellence recommends that people with hip fracture should have surgery on the day of, or the day after, admission. However, there remains unacceptable variation in performance around the country, with a range of 13-91% of patients meeting this target. Dedicated trauma lists have insufficient capacity in many hospitals. We occasionally employ a mixed-use emergency theatre to facilitate early surgery. Increased risk of infection has been raised as a concern owing to microbial surface contamination from a preceding unclean case and lack of laminar flow in these theatres...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29043506/fatigue-failure-of-the-cephalomedullary-nail-revision-options-outcomes-and-review-of-the-literature
#4
Adam Tucker, Michael Warnock, Sinead McDonald, Laurence Cusick, Andrew P Foster
Cephalomedullary nail (CMN) failure is a rare entity following hip fracture treatment. However, it poses significant challenges for revision surgery, both mechanically and biologically. Nail failure rates have been reported at < 2%; however, no published studies have reported revision surgery procedures and their respective outcomes. We present a regional experience, with outcomes, of the revision options. We identified 20 fatigued CMNs that underwent four different revision procedures. Mean age was 73 ± 15...
October 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29040233/is-the-best-plate-a-nail-a-review-of-3230-unstable-intertrochanteric-fractures-of-the-proximal-femur
#5
A Tucker, K J Donnelly, C Rowan, S McDonald, A P Foster
OBJECTIVES: The aim of the current study was to evaluate the functional outcomes, revision and mortality rates for 3 implants used for unstable intertrochanteric hip fractures; the sliding hip screw (SHS), with or without a trochanteric stabilisation plate (TSP), and cephalomedullary nail (CMN). DESIGN: Multicentre National Prospective Cohort Study SETTING:: Northern Ireland PATIENT/PARTICIPANTS:: Patients were identified from a prospective database. Fractures were classified according to AO A31A2...
October 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29040134/mortality-by-timing-of-hip-fracture-surgery-factors-and-relationships-at-play
#6
Katie Jane Sheehan, Boris Sobolev, Pierre Guy
In hip fracture care, it is disputed whether mortality worsens when surgery is delayed. This knowledge gap matters when hospital managers seek to justify resource allocation for prioritizing access to one procedure over another. Uncertainty over the surgical timing-death association leads to either surgical prioritization without benefit or the underuse of expedited surgery when it could save lives. The discrepancy in previous findings results in part from differences between patients who happened to undergo surgery at different times...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29026289/can-we-predict-postoperative-complications-in-elderly-chinese-patients-with-hip-fractures-using-the-surgical-risk-calculator
#7
Xiao Wang, Bin Jiang Zhao, Yue Su
PURPOSE: Hip fractures are associated with poor prognosis in elderly patients partly due to the high rate of postoperative complications. This study was aimed to investigate whether the surgical risk calculator is suitable for predicting postoperative complications in elderly Chinese patients with hip fractures. METHODS: The incidence of postoperative complications among 410 elderly patients with hip fractures was predicted by the surgical risk calculator and then compared with the actual value...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29026135/interventions-for-treating-displaced-intracapsular-femoral-neck-fractures-in-the-elderly-a-bayesian-network-meta-analysis-of-randomized-controlled-trials
#8
Bin-Fei Zhang, Peng-Fei Wang, Hai Huang, Yu-Xuan Cong, Hu Wang, Yan Zhuang
Displaced intracapsular femoral neck (AO type 31 B2/3) fractures have various treatments, including internal fixation (IF), unipolar uncemented hemiarthroplasty (HA), bipolar uncemented HA, unipolar cemented HA, bipolar cemented HA, uncemented total hip replacement (THR), and cemented THR. Systematic literature retrieval was performed from the databases to compare them in a network meta-analysis. Forty studies (85 arms) containing 6141 patients were included. Overall, our network meta-analysis rank the orders of 7 procedures in reoperation, mortality, dislocation and infection, which indicates that IF may provide the highest reoperation incidence, unipolar cemented HA may provide the lowest reoperation incidence; uncemented THR contributes the highest dislocation incidence; and bipolar uncemented HA provides the lowest infection incidence...
October 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29025609/blood-loss-in-trochanteric-fractures-multivariate-analysis-comparing-dynamic-hip-screw-and-gamma-nail
#9
Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo Cherubino
INTRODUCTION: Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. PURPOSE: To evaluate the blood loss in patients that had their trochanteric fracture stabilized with dynamic hip screw (DHS) or Gamma nail...
October 2017: Injury
https://www.readbyqxmd.com/read/29017580/a-retrospective-analysis-of-the-intertan-nail-and-proximal-femoral-nail-anti-rotation-in-the-treatment-of-intertrochanteric-fractures-in-elderly-patients-with-osteoporosis-a-minimum-follow-up-of-3%C3%A2-years
#10
Hui Zhang, Xiaoxiao Zhu, Genwang Pei, Xianshang Zeng, Nan Zhang, Ping Xu, Deng Chen, Weiguang Yu, Xinchao Zhang
BACKGROUND: The study aims to compare the long-term functional and radiographic outcomes of two devices for the treatment of primary intertrochanteric fractures (IFs, OTA 3.1A2.1-A2.3) in elderly patients with osteoporosis. METHODS: Between December 2010 and August 2014, 332 elderly osteoporosis patients with IFs (OTA 3.1A2.1-A2.3) fixed by an InterTAN nail (IT) or a proximal femoral nail anti-rotation (PFNA) device were retrospectively evaluated. Follow-up occurred 1, 3, 6, and 12 months postoperatively and every year thereafter...
October 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29017476/the-relationship-between-preoperative-american-society-of-anesthesiologists-physical-status-classification-scores-and-functional-recovery-following-hip-fracture-surgery
#11
Li-Huan Chen, Jersey Liang, Min-Chi Chen, Chi-Chuan Wu, Huey-Shinn Cheng, Hsiu-Ho Wang, Yea-Ing Lotus Shyu
BACKGROUND: Little is known about the relationship of the American Society of Anesthesiologists Physical Status Classification scores (ASA scores) on patient outcomes following hip fracture surgery in Asian countries. Therefore, this study explored the association of patients' preoperative ASA scores on trajectories of recovery in physical functioning and health outcomes during the first year following postoperative discharge for older adults with hip-fracture surgery in Taiwan. METHODS: The data for this study was generated from three prior studies...
October 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28991122/peripheral-nerve-blocks-for-hip-fractures-a-cochrane-review
#12
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra L Kopp
BACKGROUND: This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic. METHODS: Trials were identified by computerized searches of Cochrane Central Register of Controlled Trials (2016, Issue 8), MEDLINE (Ovid SP, 1966 to 2016 August week 1), Embase (Ovid SP, 1988 to 2016 August week 1), and the Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1982 to 2016 August week 1), trials registers, and reference lists of relevant articles...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28990979/mortality-after-high-energy-pelvic-fractures-in-patients-of-age-65-or-older
#13
Dayley S Keil, Steven Gross, Rachel B Seymour, Stephen Sims, Madhav A Karunakar
OBJECTIVES: To document in-hospital and 1-year mortality rates following high-energy pelvic fracture in patients age 65 or older as compared to a younger cohort. DESIGN: Retrospective review. SETTING: Urban level 1 academic trauma center. PATIENTS: Seventy consecutive patients age ≥ 65 years treated for pelvic fracture resulting from high-energy mechanism from 2008 to 2011. One hundred forty patients age 18-64 were matched to the study population based on mechanism of injury and OTA Code 61 subtype for comparison...
September 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28988402/nutritional-markers-may-identify-patients-with-greater-risk-of-re-admission-after-geriatric-hip-fractures
#14
Austin V Stone, Alexander Jinnah, Brian J Wells, Hal Atkinson, Anna N Miller, Wendell M Futrell, Kristin Lenoir, Cynthia L Emory
PURPOSE: Osteoporotic hip fractures are increasing in prevalence with the growing elderly population. Morbidity and mortality remain high following osteoporotic hip fractures despite advances in medical and surgical treatments. The associated costs and medical burdens are increased with a re-admission following hip fracture treatment. This study sought to identify demographic and clinical values that may be a predictive model for 30-day re-admission risk following operative management of an isolated hip fracture...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28988382/does-time-of-surgery-and-complication-have-any-correlation-in-the-management-of-hip-fracture-in-elderly-and-can-early-surgery-affect-the-outcome
#15
S K Rai, Rohit Varma, S S Wani
OBJECTIVE: Hip fractures in the elderly are usually associated with a high rate of morbidity and mortality and affect quality of life. On review of published data, the current guidelines in the literature indicate that early surgery should be performed within 24 h of injury because it is associated with better functional outcomes and lower rates of perioperative complications and mortality. The aim of this study was to evaluate whether any correlation exists between early surgical intervention and functional outcomes...
October 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28985911/hip-fractures-and-parkinson-s-disease-a-case-series
#16
Ross Coomber, Zeiad Alshameeri, Antonio Francesco Masia, Federico Mela, Martyn J Parker
There are no specific guidelines for treating Parkinson's disease patients who present with a hip fracture. Here we present a large cohort of patients with Parkinson's disease who suffered hip fractures. Our aim was to assess for differences between a Parkinson's disease population and a non-Parkinson's disease population with hip fractures and make recommendations on management guidelines. We performed a comprehensive analysis of prospectively collected data on all patients with hip fracture who were admitted into our department over a period of 29 years...
August 25, 2017: Injury
https://www.readbyqxmd.com/read/28984572/total-hip-arthroplasty-via-the-direct-anterior-approach-with-a-dual-mobility-cup-for-displaced-femoral-neck-fracture-in-patients-with-a-high-risk-of-dislocation
#17
Hironori Ochi, Tomonori Baba, Yasuhiro Homma, Mikio Matsumoto, Taiji Watari, Yu Ozaki, Hideo Kobayashi, Kazuo Kaneko
INTRODUCTION: Although total hip arthroplasty (THA) is superior to bipolar hemiarthroplasty (BHA) for displaced femoral neck fracture in terms of hip pain, function and reoperation rate, THA has a higher rate of dislocation. The direct anterior approach (DAA) and a dual mobility cup (DMC) are associated with lower rates of dislocation. The aim of this study was to investigate the outcomes of THA compared with BHA, and in those patients who had a THA we investigated those with a DMC (DMC-THA) and compared them with those had a single conventional cup (Single cup-THA)...
2017: SICOT-J
https://www.readbyqxmd.com/read/28984060/a-practical-approach-to-the-management-of-nocturia
#18
Matthias Oelke, Stefan De Wachter, Marcus J Drake, Antonella Giannantoni, Mike Kirby, Susan Orme, Jonathan Rees, Philip van Kerrebroeck, Karel Everaert
AIM: To raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways. METHODS: A multidisciplinary group of nocturia experts developed practical advice and recommendations based on the best available evidence supplemented by their own experiences. RESULTS: Nocturia is defined as the need to void ≥1 time during the sleeping period of the night. Clinically relevant nocturia (≥2 voids per night) affects 2%-18% of those aged 20-40 years, rising to 28%-62% for those aged 70-80 years...
October 5, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28983383/the-incidence-of-hip-fractures-in-long-term-care-homes-in-saskatchewan-from-2008-to-2012-an-analysis-of-provincial-administrative-databases
#19
Lilian U Thorpe, Susan J Whiting, Wenbin Li, William Dust, Thomas Hadjistavropoulos, Gary Teare
BACKGROUND: Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics. METHODS: We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur...
September 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28977869/prognostic-value-of-the-c-reactive-protein-prognostic-nutritional-index-ratio-after-hip-fracture-surgery-in-the-elderly-population
#20
Hanru Ren, Lianghao Wu, Wankun Hu, Xiuzhang Ye, Baoqing Yu
BACKGROUND: More and more older patients receive the surgery after hip fracture. However, the mortality rate is high. Prognostic nutritional index (PNI) is associated with prognosis in hip fracture patients. In the current study, we proposed a novel prognostic score, named c-reactive protein/PNI ratio (CRP/PNI ratio), for predicting the prognosis for geriatric orthopedic population. METHODS: This is a prospective study. Eighty cases of hip fracture surgery in the elderly population were studied to reveal the relationship between the CRP/PNI ratio and the clinicopathological characteristics of the elderly patients...
September 22, 2017: Oncotarget
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