scholarly journals 274 Use of DHS For Fixation of Unstable Hip Fractures – Are Outcomes Any Different from Nails?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Arora
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Hip Fractures ◽  
Mortality Rates ◽  
Ao Classification ◽  
Significant Difference ◽  
Acute Complications ◽  
Delayed Complications

Abstract Aim To determine if the outcomes and rate of complications differ based on choice of implant for unstable hip fractures. Method Retrospective analysis of 105 hip fractures operated in 2015 + 2016 with AO classification A2.2. A2.3 or A3. These were divided into 2 groups depending on whether DHS/Plate implant was selected (n = 86) or Nail implant was used (n = 19). Any complications occurring in their subsequent management or performance of any revision procedures were recorded. 6-month mortality rate was also calculated for both groups. Results When A2 and A3 fractures were assessed together the rate of acute complications was similar in both groups. 21% for nails and 19% for plates. The rate of delayed complications was not significantly different either, 16% for nails and 10% for plates. Revision procedures were more common where nails had been used (16%) compared to only 6% of plate fixations. Mortality rates were identical. When looking at A3 fractures in isolation, the rate of delayed complications is significantly higher when plates are used (24%) compared to 12% when nails are selected. Conclusions We did not identify any significant difference in acute complications including bleeding and infection based on choice of implant. This goes against common arguments raised against use of nails. Successful use of DHS fixation in unstable A2 hip fractures is possible, as evidenced by similar rates of delayed complications. Revisions were higher when nail was selected. It is however noted that for reverse oblique fractures nails perform demonstrably better, with half as frequent delayed complications and revisions.

scholarly journals Do we really need a surgery for hip fractures in elderly patients? Mortality rate and influencing factors

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Kyu-Tae Hwang ◽  
Jun-Ki Moon ◽  
Young-Ho Kim
Keyword(s):  
Heart Disease ◽  
Treatment Group ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Influencing Factors ◽  
Hip Fractures ◽  
Mortality Rates ◽  
Factors Associated ◽  
Surgical Methods ◽  
Significant Difference

Abstract Background Hip fractures are associated with notable mortality rates in elderly patients. The purpose of the study was to evaluate the mortality rate and influencing factors associated with mortality in the elderly patients with hip fractures. Methods Between October 2000 and December 2009, 807 elderly patients with hip fractures were enrolled in this study. There were 197 men and 610 women. The mean age at injuries were 78 years (range, 65–99 years). The fractures consisted of 390 femoral neck fractures and 417 intertrochanteric fractures. The mortality rate was evaluated between patients who underwent surgical and nonsurgical treatments. The influencing factors associated with mortality rate were evaluated statistically. Results Overall, 691 (85.6%) patients treated surgically and 116 (14.4%) patients treated nonsurgically were included. The overall mortality rates one and two years after injuries were 16.6 and 39.4%, respectively. In surgical treatment group, the mortality rate one and two years after injuries were 12.0 and 35.7%, respectively. In nonsurgical treatment group, the mortality rates were 44.0 and 61.2%, respectively (p < 0.05). No significant difference was noted between the types of fractures and the time from injury to surgery. Regardless of surgical methods, a significantly higher mortality rate was observed in patients with heart disease, chronic renal disease, dementia, and cancer, or in patients with 3 or more comorbidities. Conclusions In elderly patients with hip fractures, surgical treatments can decrease the mortality rate as compared with nonsurgical treatments. In addition, patients who had three or more comorbidities (heart disease, chronic renal failure, dementia, and history of cancer) are associated with a higher risk of mortality. Trial registration Retrospectively registered.

Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

2020 ◽  
pp. fetalneonatal-2020-319093
Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Neonatal Mortality Rate ◽  
England And Wales ◽  
Neonatal Deaths ◽  
Live Births ◽  
Extremely Preterm ◽  
Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

scholarly journals A study on transformation in infant mortality rates in India: mortality indicators as major tool for indicating status of nation’s health

2020 ◽  
Vol 7 (3) ◽  
pp. 647
Author(s):  
Chandramohan Reddy S. ◽  
Dharna Reddy
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Sex Ratio ◽  
Rural Areas ◽  
Population Change ◽  
Principal Component ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
P Value ◽  
Significant Difference

Background: Mortality is important to study population change in the country; infant mortality is considered as principal component balancing the child sex ratio. In this study authors aimed to analyze how mortality rates and child sex ratios are different in urban and rural areas and how its growth statistics are changing over years. Objectives of the study were to quantify infant mortality rates change over time and check the means among mortality indicators.Methods: The study was conducted using secondary data obtained from various issues and reports published by Registrar General and Census Commissioner, India for a period of 10 years from 2006 to 2016. The obtained data on mortality indicators were subjected to basic statistical analysis using percent change and paired t-test.Results: The Infant mortality rate which was reduced by 23 points indicating reduction of 67.65 percent control over a period from 2006 to 2016. Further, results show that, in case of urban mortality, there was significant difference between mortality indicators during study period, the p-value (0.011) was less than level of significance (0.05) so we reject the null hypothesis and it is concluded that there is significant difference between the means of urban mortality indicators over a period of from 2006 to 2016.Conclusions: The infant mortality rate frequently provided as a key indicator of overall the development. There is need for stable child sex ratio; health of children and women are essential for better growth and reaching stable child sex ratio for the ever increasing population.

scholarly journals Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

2017 ◽  
Vol 05 (05) ◽  
pp. E389-E394 ◽  
Author(s):  
Sherine Khater ◽  
Gabriel Rahmi ◽  
Guillaume Perrod ◽  
Elia Samaha ◽  
Hedi Benosman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Ureteral Obstruction ◽  
Mortality Rates ◽  
The Other ◽  
Significant Difference ◽  
Before And After ◽  
Over The Scope Clip ◽  
Time Periods ◽  
Second Period

Abstract Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.

scholarly journals (P2-25) Evaluation of the Apache III Grading System in Predicting the Prognosis and Mortality of Patients Admitted to Emergency Room, in Need of Intensive Care Unit Admission

2011 ◽  
Vol 26 (S1) ◽  
pp. s143-s144
Author(s):  
H. Hatamabadi ◽  
P. Darbandsar ◽  
A. Abdalvand ◽  
H. Kariman ◽  
A. Arhamidolatabadi
Keyword(s):  
Mortality Rate ◽  
Scoring System ◽  
Mortality Rates ◽  
Cross Sectional ◽  
Lengths Of Stay ◽  
Apache Iii ◽  
Study Results ◽  
Significant Difference ◽  
Critical Patients ◽  
One Year

ObjectivesMany of critically ill patients are being cared for prolonged periods in ED just because of limited number of ICU beds and utilize of ED as the entry point to the health care system. The aim of this study is evaluation efficiency of APACHE III scoring system in predicting mortality rate of the mentioned patients.Materials and MethodsThis cross-sectional, observational, analytic study was performed in one year period. A hundred patients remaining in ED and necessitating ICU hospitalizing were enrolled by the convenience type of non-probability sampling. Then, the APACHE III scores, predicted and observed mortality rates were calculated using of information obtained from patients' files, interview with the patients' family and performing required physical exams and lab tests.ResultsIn the assessment of 100 patients, men group were 56% (56) and women group 44% (44). The age of patients and the ED lengths of stay were 66.07 ± 19.92 years and 5.11 ± 3.79 days respectively. The average (± SD) of APACHE III score of the enrolled patients was 58.89 ± 18.24 and the predicted mortality rate calculated 32.73%; while, the total of observed mortality rate was 55%. The average (± SD) of APACHE III score of survivors and non-survivors were 48.63 ± 16.35 and 67.63 ± 14.84 respectively. So, there was a significant deference (p < 0.001). Also, there was a significant deference in the ED lengths of stay between survivors and non-survivors (3.20 ± 1.34 and 6.57 ± 4.40 respectively, p < 0.001).ConclusionIn our study, APACHE III score and ED lengths of stay were higher versus other studies in Iran and other countries; which show more critical patients presenting to our hospital and limited ICU beds versus patients. This study results nevertheless there was significant difference between predicted and observed mortality rates, the APACHE III scoring system is applicable to evaluating care, treatment and prognosis of ED patients, as is used in ICU.

scholarly journals The Effect of COVID-19 Pandemic on the Hip Fractures in Advanced Age

2021 ◽  
Author(s):  
Ahmet Metin Özsezen ◽  
Ahmet Burak Bilekli ◽  
Anıl Özgür ◽  
Onur Denizhan Sivri ◽  
Çağrı Neyişçi ◽  
...  
Keyword(s):  
Primary Care ◽  
Hip Fractures ◽  
The Elderly ◽  
Mortality Rates ◽  
Demographic Characteristics ◽  
Low Energy ◽  
Primary Care Unit ◽  
Significant Difference ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective: Hip fractures due to domestic low-energy traumas are common problems that can cause significant morbidity and mortality in the elderly population. Since the Covid-19 outbreak, although the lock-down of older people could decrease contagion,the incidence of domestic traumas did not decrease, and led to development of various comorbidities. In this study, we aimed to compare the epidemiology of hip fractures in 6 months of the pandemic in 2020, with the equivalent 6-month period in the previous year to determine the relationship between lock-down and hip fractures due to domestic falls. Method: In this retrospective study, patients over 65 years old who were hospitalized due to hip fractures between May 1st, 2020 - November 30th, 2020 were compared with the similar cohort hospitalized between May 1st, 2019 - November 30th, 2019. The patients were compared in terms of demographic characteristics, American Society of Anesthesiologists (ASA) scores, type of anesthesia, time until surgery, comorbidities, surgical treatment modality, need for postoperative primary care unit, postoperative complications, and mortality. Results: Overall, 210 patients were included in our study. There was no significant difference between the groups regarding demographic characteristics and ASA scores. In the 2020 group, there were eight patients (8.6%) who were Covid-19 PCR- positive. There was no death proven by PCR that was related to COVID-19 disease. Time to surgery, fracture type, anesthesia type did not differ between the two groups. The need for a postoperative primary care unit was higher in the 2020 group. Ninety-day mortality rates were not significantly different between the two groups. Conclusions: In conclusion, despite higher mortality rates described in the literature, there was no Covid -19 associated mortality in our study. Hip fractures in the elderly did not alter with social mobilization; hence they usually occur due to domestic low- energy traumas. Reporting of the information in this patient group by all centers will provide important data in the management of hip fractures in this special process.

scholarly journals Influence of Housing System and Number of Transported Animals on Transport-induced Mortality in Slaughter Pigs

2010 ◽  
Vol 79 (9) ◽  
pp. S79-S84 ◽  
Author(s):  
Eva Voslářová ◽  
Petr Chloupek ◽  
Ladislav Steinhauser ◽  
Jan Havlíček ◽  
Vladimír Večerek
Keyword(s):  
Czech Republic ◽  
Mortality Rate ◽  
Mortality Rates ◽  
Housing System ◽  
The Czech Republic ◽  
Significant Difference ◽  
Slaughter Pigs ◽  
Load Size

The study monitored the effect of the housing system and the number of animals transported together on transport-induced mortality of slaughter pigs in the Czech Republic in the period from 2004 to 2008. Concerning the type of housing during the fattening, the lowest mortality rate during the subsequent transport to slaughter houses was detected among pigs fattened on solid floor (0.047%) and on deep bedding (0.084%). The highest mortality during transport was detected among pigs fattened on fully or partially slatted floor (0.139%), a significant difference (p < 0.01) was found compared to other housing types. Assessment of the influence of individual pig load size on mortality showed the lowest mortality among pigs transported in loads of up to 40 animals (0.053%). Mortality during the transport in loads of the size of 41 to 120 animals was 0.130%, and for loads of the size over 120 pigs the mortality rate was 0.156%. These mortality rates are significantly higher (p < 0.01) compared to the load sizes of up to 40 animals.

scholarly journals A Comparison of Mortality following Distal Femoral Fractures and Hip Fractures in an Elderly Population

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
R. W. Jordan ◽  
G. S. Chahal ◽  
M. Davies ◽  
K. Srinivas
Keyword(s):  
Mortality Rate ◽  
Hip Fractures ◽  
Femoral Fracture ◽  
Elderly Population ◽  
Surgical Intervention ◽  
Femoral Fractures ◽  
Mortality Rates ◽  
Distal Femoral Fracture ◽  
Distal Femoral Fractures ◽  
One Year

Introduction. Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. Currently this cohort is not afforded the same resources as those with hip fractures. This study aims to compare their mortality rates and assess whether surgical intervention improves either outcome or mortality following distal femoral fractures. Methods. Patients over sixty-five admitted with a distal femoral fracture between June 2007 and 2012 were retrospectively identified. Patients mobility was categorised as unaided, walking aid, zimmer frame, or immobile. The 30-day, six-month, and one-year mortality rates were recorded for this group as well as for hip fractures during the same period. Results. 68 patients were included in the study. The mortality rate for all patients with distal femoral fractures was 7% at 30 days, 26% at six months, and 38% at one year, higher than hip fractures during the same period by 8%, 13%, and 18%, respectively. Patients managed surgically had lower mortality rates and higher mobility levels. Conclusion. Patients suffering a distal femoral fracture have a high mortality rate and surgical intervention seems to improve both mobility and mortality.

scholarly journals Learning Interpretable Mixture of Weibull Distributions—Exploratory Analysis of How Economic Development Influences the Incidence of COVID-19 Deaths

Data ◽  
2021 ◽  
Vol 6 (12) ◽  
pp. 125
Author(s):  
Róbert Csalódi ◽  
Zoltán Birkner ◽  
János Abonyi
Keyword(s):  
Mortality Rate ◽  
Health Sector ◽  
Mortality Rates ◽  
Regression Method ◽  
Distribution Functions ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Significant Difference ◽  
Weibull Models ◽  
Cox Proportional Hazard Regression

This paper presents an algorithm for learning local Weibull models, whose operating regions are represented by fuzzy rules. The applicability of the proposed method is demonstrated in estimating the mortality rate of the COVID-19 pandemic. The reproducible results show that there is a significant difference between mortality rates of countries due to their economic situation, urbanization, and the state of the health sector. The proposed method is compared with the semi-parametric Cox proportional hazard regression method. The distribution functions of these two methods are close to each other, so the proposed method can estimate efficiently.

scholarly journals Mortality incidence and its determinants after fragility hip fractures: a prospective cohort study from an Egyptian level one trauma center

2021 ◽  
Vol 21 (2) ◽  
pp. 806-816
Author(s):  
Mohammad K Abdelnasser ◽  
Ahmed A Khalifa ◽  
Khaled G Amir ◽  
Mohammad A Hassan ◽  
Amr A Eisa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hip Fractures ◽  
Prospective Cohort ◽  
Mortality Rates ◽  
Trochanteric Fractures ◽  
Fragility Hip Fracture ◽  
One Year

Background: Fragility hip fracture is a common condition with serious consequences. Most outcomes data come from Western and Asian populations. There are few data from African and Middle Eastern countries. Objective: The primary objective was to describe mortality rates after fragility hip fracture in a Level-1 trauma centre in Egypt. The secondary objective was to study the causes of re-admissions, complications, and mortality. Methods: A prospective cohort study of 301 patients, aged > 65 years, with fragility hip fractures. Data collected included sociodemographic, co-morbidities, timing of admission, and intraoperative,ostoperative, and post-discharge data as mortal- ity, complications, hospital stay, reoperation, and re-admission. Cox regression analysis was conducted to investigate factors associated with 1-year mortality. Results: In-hospital mortality was 8.3% (25 patients) which increased to 52.8% (159 patients) after one year; 58.5% of the deaths occurred in the first 3-months. One-year mortality was independently associated with increasing age, ASA 3-4, cardiac or hepatic co-morbidities, trochanteric fractures, total hospital stay, and postoperative ifection and metal failure. Conclusion: Our in-hospital mortality rate resembles developed countries reports, reflecting good initial geriatric health- care. However, our 3- and 12-months mortality rates are unexpectedly high. The implementation of orthogeriatric care after discharge is mandatory to decrease mortality rates. Keywords: Fragility hip fractures; trochanteric fractures; mortality rate.

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