Document Detail


Influence of health status and the timing of surgery on mortality in hip fracture patients.
MedLine Citation:
PMID:  9316725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the study was to determine the relationship of preoperative health status and time to surgery to mortality and late functional outcome in hip fracture patients. The records of 168 consecutive patients who had operations for 171 intertrochanteric or femoral neck fractures were reviewed retrospectively. Preoperative health status was assessed by the American Society of Anesthetists (ASA) classification. Postoperative outcome was determined by mortality and ambulatory status. The follow-up period for survivors averaged 33 months. The overall mortality was 14% at 1 year, which rose to 26% at 2 years, and 33% at 3 years. The 3-year mortality was significantly less for ASA I and II patients (23%) than for ASA III, IV, and V patients (39%). There was also a significant difference in mortality between patients having surgery within 24 hours of admission (20%) and those having surgery beyond 24 hours of admission (50%). Even when only the healthy subgroup of ASA I and II patients were considered, the relative risk of death was 4.5 times greater if surgery occurred after 24 hours from admission. These data support the concept that hip fracture patients are not a homogeneous group with respect to mortality and that the ASA classification is a good predictor of mortality. Patients who had surgery within 24 hours of admission had a significantly lower mortality rate than did patients having surgery beyond 24 hours of admission, regardless of their preoperative ASA classification.
Authors:
W P Hamlet; J R Lieberman; E L Freedman; F J Dorey; A Fletcher; E E Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of orthopedics (Belle Mead, N.J.)     Volume:  26     ISSN:  1078-4519     ISO Abbreviation:  Am J. Orthop.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-26     Completed Date:  1997-11-26     Revised Date:  2010-01-05    
Medline Journal Info:
Nlm Unique ID:  9502918     Medline TA:  Am J Orthop (Belle Mead NJ)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  621-7     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, UCLA School of Medicine, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Femoral Neck Fractures / mortality,  surgery*
Follow-Up Studies
Health Status*
Hip Fractures / mortality,  surgery*
Humans
Length of Stay / statistics & numerical data
Male
Middle Aged
Postoperative Complications / mortality*
Retrospective Studies
Risk
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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