Influence of Comorbidities and Delay in Surgical Treatment on Mortality Following Femoral Neck Fracture
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Influence of Comorbidities and Delay in Surgical Treatment on Mortality Following Femoral Neck Fracture. / Andruszkow, H; Scharff, B; Zapf, A; Klein, M; Lechler, P; Hildebrand, F; Frink, M.
In: Z ORTHOP UNFALLCHIR, Vol. 151, No. 4, 08.2013, p. 338-342.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Influence of Comorbidities and Delay in Surgical Treatment on Mortality Following Femoral Neck Fracture
AU - Andruszkow, H
AU - Scharff, B
AU - Zapf, A
AU - Klein, M
AU - Lechler, P
AU - Hildebrand, F
AU - Frink, M
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2013/8
Y1 - 2013/8
N2 - Background: Hip fractures typically occur in geriatric patients representing an increasing medical as well as socioeconomic challenge. Patients and Methods: In order to reveal the influence of considerable comorbidities and the time of surgery in the treatment of geriatric hip fractures we analysed patients treated between 1993 and 2008 at a level I trauma centre. Results: 654 patients with isolated hip fractures were included. Surgical treatment was performed with osteosynthetic stabilisation in 55.5 % (n = 363) and with endoprosthetic implants in 44.5 % (n = 291). The presence of pulmonary, psychiatric and metabolic/endocrinological comorbidities resulted in delayed treatment. If an early surgical treatment was performed within the first 12 hours after hospital admission, long-term survival was significantly improved (p = 0.02). A regression analysis revealed a statistical trend towards an increased mortality of 0.2 % per hour delay after hospital admission. The presence of considerable comorbidities and surgical treatment with endoprosthetic implants (odds ratio 1.611) were proven as independent mortality factors. Conclusion: The present study supports the guideline of early surgical treatment of geriatric hip fractures. Emphasising the incidence of in-hospital complications and the mortality after endoprosthetic treatment, osteosynthetic fracture stabilisation should be considered in the presence of considerable morbidity and pre-surgical immobilisation.
AB - Background: Hip fractures typically occur in geriatric patients representing an increasing medical as well as socioeconomic challenge. Patients and Methods: In order to reveal the influence of considerable comorbidities and the time of surgery in the treatment of geriatric hip fractures we analysed patients treated between 1993 and 2008 at a level I trauma centre. Results: 654 patients with isolated hip fractures were included. Surgical treatment was performed with osteosynthetic stabilisation in 55.5 % (n = 363) and with endoprosthetic implants in 44.5 % (n = 291). The presence of pulmonary, psychiatric and metabolic/endocrinological comorbidities resulted in delayed treatment. If an early surgical treatment was performed within the first 12 hours after hospital admission, long-term survival was significantly improved (p = 0.02). A regression analysis revealed a statistical trend towards an increased mortality of 0.2 % per hour delay after hospital admission. The presence of considerable comorbidities and surgical treatment with endoprosthetic implants (odds ratio 1.611) were proven as independent mortality factors. Conclusion: The present study supports the guideline of early surgical treatment of geriatric hip fractures. Emphasising the incidence of in-hospital complications and the mortality after endoprosthetic treatment, osteosynthetic fracture stabilisation should be considered in the presence of considerable morbidity and pre-surgical immobilisation.
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Femoral Neck Fractures
KW - Geriatric Assessment
KW - Germany
KW - Humans
KW - Incidence
KW - Lung Diseases
KW - Male
KW - Mental Disorders
KW - Metabolic Diseases
KW - Postoperative Complications
KW - Retrospective Studies
KW - Risk Assessment
KW - Survival Rate
KW - Treatment Outcome
KW - Waiting Lists
KW - English Abstract
KW - Journal Article
U2 - 10.1055/s-0032-1328665
DO - 10.1055/s-0032-1328665
M3 - SCORING: Zeitschriftenaufsatz
C2 - 23817802
VL - 151
SP - 338
EP - 342
JO - Z ORTHOP UNFALLCHIR
JF - Z ORTHOP UNFALLCHIR
SN - 1864-6697
IS - 4
ER -