scholarly journals Morbidity and mortality after fragility hip fracture in a Saudi Arabian population: Report from a single center

2017 ◽  
Vol 45 (3) ◽  
pp. 1175-1180 ◽  
Author(s):  
Mir Sadat-Ali ◽  
Moaad Alfaraidy ◽  
Abdulaziz AlHawas ◽  
Ahmed Abdallah Al-Othman ◽  
Dakheel A Al-Dakheel ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Demographic Data ◽  
Femoral Fractures ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Fragility Hip Fracture ◽  
Asa Score ◽  
Telephone Interviews ◽  
American Society

Objective To determine the functional morbidity and mortality after fragility hip fracture and compare the mortality with three other common diseases. Methods Data were collected from patients admitted to King Fahd Hospital of the University, AlKhobar from January 2010 to December 2014. Demographic data included the preoperative American Society of Anesthesiologists (ASA) score as assessed by the anesthetist and the type of surgery. Personal and telephone interviews were performed, and data were entered into a database and analyzed. Results We identified 203 patients with fragility proximal femoral fractures, and the data of 189 patients (109 male, 80 female; average age, 66.90 ± 13.43 years) were available for analysis. The overall mortality rate was 26.98% (51 patients). The mortality rate was significantly higher among patients with an ASA score of 4 (36.36%) than 1 (20.45%). With respect to morbidity, only 48.23% of patients were able to return to their pre-fracture status; 32.35% of those who required assisted walking and 83.4% of those who required a wheelchair became bedridden. Conclusions Our data demonstrate that patients with fragility hip fractures have high morbidity and a mortality rate approaching 30%. Age and the ASA score significantly influence this high mortality rate.

Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

2020 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Operative Time ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

scholarly journals Infection Versus Hematoma Following Surgical Treatment of Proximal Femoral Fractures in Geriatric Patients

2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Author(s):  
Franz Müller ◽  
Michael Galler ◽  
Christina Roll ◽  
Bernd Füchtmeier
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Treatment ◽  
Geriatric Patients ◽  
Femoral Fractures ◽  
Morbidity And Mortality ◽  
Control Group ◽  
Postoperative Phase ◽  
High Morbidity ◽  
Proximal Femoral Fractures

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

scholarly journals POSSUM and P-POSSUM Scoring in Hip Fracture Mortalities

2020 ◽  
Vol 11 ◽  
pp. 215145932093167
Author(s):  
William L. Johns ◽  
Benjamin Strong ◽  
Stephen Kates ◽  
Nirav K. Patel
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Mortality Rate ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Significant Risk ◽  
Screening Tools ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Introduction: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) are general surgical tools used to efficiently assess mortality and morbidity risk. Data suggest that these tools can be used in hip fracture patients to predict morbidity and mortality; however, it is unclear what score indicates a significant risk on a case-by-case basis. We examined the POSSUM and P-POSSUM scores in a group of hip fracture mortalities in order to assess their accuracy in identification of similar high-risk patients. Materials and Methods: Retrospective analysis of all consecutive mortalities in hip fracture patients at a single tertiary care center over 2 years was performed. Patient medical records were examined for baseline demographics, fracture characteristics, surgical interventions, and cause of death. Twelve physiological and 6 operative variables were used to retrospectively calculate POSSUM and P-POSSUM scores at the time of injury. Results: Forty-seven hip fracture mortalities were reviewed. Median patient age was 88 years (range: 56-99). Overall, 68.1% (32) underwent surgical intervention. Mean predicted POSSUM morbidity and mortality rates were 73.9% (28%-99%) and 31.1% (5%-83%), respectively. The mean predicted P-POSSUM mortality rate was 26.4% (1%-91%) and 53.2% (25) had a P-POSSUM predicted mortality of >20%. Subgroup analysis demonstrated poor agreement between predicted mortality and observed mortality rate for POSSUM in operative (χ2 = 127.5, P < .00001) and nonoperative cohorts (χ2 = 14.6, P < .00001), in addition to P-POSSUM operative (χ2 = 101.9, P < .00001) and nonoperative (χ2 = 11.9, P < .00001) scoring. Discussion/Conclusion: Hip fracture patients are at significant risk of both morbidity and mortality. A reliable, replicable, and accurate tool to represent the expected risk of such complications could help facilitate clinical decision-making to determine the optimal level of care. Screening tools such as POSSUM and P-POSSUM have limitations in accurately identifying high-risk hip fracture patients.

scholarly journals Potential of Allicin, Ajoene and Quercetin Contained in Garlic (Allium sativum) as a Promising Anti-Malarial

2021 ◽  
Vol 1 (1) ◽  
pp. 16-21
Author(s):  
Raynald Bagy ◽  
Josef Sem Berth Tuda ◽  
Dimas Prakoso ◽  
Tristan Kantohe
Keyword(s):  
Infectious Disease ◽  
Drug Resistance ◽  
Mortality Rate ◽  
Literature Review ◽  
Allium Sativum ◽  
Relevant Literature ◽  
Anopheles Mosquito ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Active Substances

Malaria is an infectious disease with a high morbidity and mortality rate caused by Plasmodium and is transmitted through the Anopheles mosquito. Garlic (Allium sativum) has active substances that can be used as medicinal ingredients. Several active substances, namely allicin, ajoene, and quercetin contained in garlic have the potential to act as an effective and safe anti plasmodium for the host. This writing is a literature review using relevant literature. The results of the study concluded that the active ingredients in garlic have potential to be a new antimalarial agent, and it is hoped that it can be a cheaper and more effective malaria treatment so that drug resistance and morbidity and mortality from malaria can be reduced.

scholarly journals A case–control study of 30-day mortality in periprosthetic hip fractures and hip fractures

2020 ◽  
Vol 102 (3) ◽  
pp. 229-231
Author(s):  
T Jennnison ◽  
R Yarlagadda
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Control Study ◽  
Femoral Fractures ◽  
Periprosthetic Fractures ◽  
Power Calculation ◽  
Single Institution ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Control Study

Introduction There are increasing numbers of periprosthetic femoral fractures, which have high mortality rates. These fractures occur in a similar demographic to hip fractures. There has been limited research on mortality following these fractures. This study compared 30-day mortality in periprosthetic hip fractures with case-matched hip fractures. Materials and methods Case notes of periprosthetic hip fractures between 1 January 2009 and 31 December 2015 were reviewed retrospectively at a single institution. There were 173 periprosthetic hip fractures over the seven years of the study. All hip fractures attending the same institution have data collected prospectively for the National Hip Fracture Database. Data were analysed from the Hip Fracture Database. A power calculation was undertaken; 173 periprosthetic hip fractures were matched to 865 hip fractures individually for age, sex, American Society of Anesthesiologists grade and capacity. Results The median wait to surgery was 88 hours for periprosthetic fractures and 23 hours for hip fractures (p < 0.00001); 22.5% of patients with periprosthetic fractures underwent surgery within 36 hours compared with 68.2% of those with hip fractures (p < 0.0001). The median length of stay was 16 days for periprosthetic fractures and 10 days for hip fractures (p < 0.00001). The 30-day mortality was 6.4% for periprosthetic hip fractures and 3.1% for case-matched hip fractures (odds ratio 2.11, 95% confidence interval 1.03–4.36; p = 0.043). Conclusions Periprosthetic hip fractures have a significantly higher mortality than hip fractures. Further research should aim to improve outcomes in these patients.

Emergent Right Hemicolectomies

2005 ◽  
Vol 71 (8) ◽  
pp. 653-657 ◽  
Author(s):  
Amy D. Wyrzykowski ◽  
David V. Feliciano ◽  
Timothy A. George ◽  
Lorraine N. Tremblay ◽  
Grace S. Rozycki ◽  
...  
Keyword(s):  
Damage Control ◽  
Primary Anastomosis ◽  
Bowel Perforation ◽  
Demographic Data ◽  
Wound Dehiscence ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Trauma Patients ◽  
Abdominal Abscess

Emergent right hemicolectomies have historically been associated with surprisingly high morbidity and mortality rates. A retrospective review of emergent right hemicolectomies over a 7-year period was performed to assess current morbidity and mortality. Emergent right hemicolectomy was defined as a procedure performed for an acute abdomen with no formal preoperative cleansing of the colon. Demographic data, diagnostic evaluation, length of stay and outcomes were evaluated. Over the study period, 122 emergent right hemicolectomies were performed on both general surgery and trauma patients. The average patient was 52.9 ± 18.5 years old, and the majority of patients (66.4%) were male. The indications for the procedures performed were bowel perforation (51), hemorrhage (25), cancer (16), benign obstruction (14), phlegmon (8), ischemia (6), or other (2). Resection with primary anastomosis was performed in 98 patients, 16 had an end ileostomy, and 8 underwent damage control procedures in which gastrointestinal continuity was not reestablished at the time of the original operation. Postoperative complications developed in 48 patients (39.3%). The majority of the complications (83.3%) were related to infection including intra-abdominal abscess (21 patients), sepsis (16), and wound infection (5). Other complications included anastomotic leak (5), wound dehiscence (3), stoma-related (3) and postoperative bowel obstruction (2). The patients who developed complications did not differ from those who had an uneventful postoperative course in terms of age, indication for procedure, or presence of intra-abdominal abscess or gross contamination at the time of the original procedure. The overall mortality rate was 13 per cent. Patients who died were older than those who lived (63 ± 19 vs 52 ± 18; P = 0.03) and were significantly more likely to have evidence of shock on presentation ( P = 0.0013). Emergent right hemicolectomies continue to be associated with high morbidity and mortality rates. The most common complications are related to infection. Age and manifestations of shock at the time of admission are strong predictors of mortality.

scholarly journals Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Rachel V. Thakore ◽  
Young M. Lee ◽  
Vasanth Sathiyakumar ◽  
William T. Obremskey ◽  
Manish K. Sethi
Keyword(s):  
Hip Fracture ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Hospital Charges ◽  
Physical Status ◽  
Asa Score ◽  
Inpatient Services ◽  
Operative Fixation ◽  
Level I ◽  
American Society

Purpose.To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services.Materials and Methods.A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services.Results.Inpatient and postoperative charges and services were significantly associated with patients’ ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2.Conclusions.A patient’s ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient’s preoperative physical status.

scholarly journals Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

2021 ◽  
Vol 12 ◽  
pp. 215145932110245
Author(s):  
Tomas Zamora ◽  
Felipe Sandoval ◽  
Hugo Demandes ◽  
Javier Serrano ◽  
Javiera Gonzalez ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Latin American ◽  
Clinical Information ◽  
The Elderly ◽  
Older Age ◽  
Morbidity And Mortality ◽  
Level Of Evidence ◽  
Fragility Hip Fracture

Introduction: Hip fracture patients have been severely affected by the COVID-19 pandemic; however, the sub acute effects of a concomitant SARS-CoV-2 infection and the outcomes in highly exposed developing countries are still unknown. Our objective is to describe the morbidity and mortality of elderly patients admitted for a hip fracture during the COVID-19 pandemic in Chile, with a minimum 90-day follow-up. Also, to elucidate predictors for mortality and to compare mortality results with the pre-pandemic era. Material and Methods: Multicentric retrospective review of patients admitted for a fragility hip fracture in 3 hospitals during the COVID-19 pandemic, and during the same time in 2019. All clinical information and images were recorded, and patients were followed for a minimum of 90-days. Morbidity and mortality were the primary outcomes. Uni/multivariable models were performed to elucidate predictors for mortality utilizing the Weibull’s regression. Results: Three hundred ninety-one cases were included. From the 2020 cohort (162 patients), 24 (15%) had a concomitant SARS-CoV-2 infection. Fourteen patients (58%) tested positive after admission. The COVID-19(+) group had a higher risk of in-hospital, 30-day, and 90-day mortality (p < 0.001). They also had a prolonged hospital stay and presented with more complications and readmissions (p < 0.05). Only COVID-19(+) status and older age were independent predictors for mortality with a HR = 6.5 (p = < 0.001) and 1.09 (p = 0.001), respectively. The 2020 cohort had twice the risk of mortality with a HR = 2.04 (p = 0.002) compared to the 2019 cohort. However, comparing only the COVID-19 (-) patients, there was no difference in mortality risk, with a HR = 1.30 (p = 0.343). Discussion: The COVID-19 pandemic has significantly affected healthcare systems and elderly patients. Conclusions: Hip fracture patients with a concomitant SARS-CoV-2 virus infection were associated with increased morbidity and mortality throughout the first 3 months. COVID-19 status and older age were significant predictors for mortality. Efforts should be directed into nosocomial infection reduction and prompt surgical management. Level of evidence: Level III

scholarly journals Cerebral Abscess with Cranial Hypertension in Young Infants: A Case Report and Systematic Review

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Náthalie Angélica Cardoso Marqui ◽  
Marina Lucca de Campos Lima ◽  
Rafaela de Fátima Ferreira Baptista ◽  
Rawene Elza Veronesi Gonçalves Righetti ◽  
Tauane Rene Martins ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Broad Spectrum ◽  
Central Nervous System Infection ◽  
Mass Effect ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Surgical Drainage ◽  
Young Infants

Objective: To report a Central Nervous System infection evolving with brain abscess and to address aspects of the treatment of the disease. Results: even with advances in treatment and diagnosis, the pathology has a high mortality. However, the best prognosis is noticed when there is a suspicion through the clinic, neuroradiological images readily available, antimicrobial therapy against commonly encountered agents, and surgical drainage procedures. One study, which combined antibiotic therapy and surgery to drain the abscess, in most of the cases, studied, demonstrated a mortality rate of 12%, and another study, a 42% mortality rate when using antibiotic therapy alone. Another reference suggests the use of antibiotic therapy alone in less severe cases with less neurological impairment. Neurological clinical sequelae can be found in up to 30% of cases. The time of antibiotic therapy still needs to be debated, as well as the surgical indication for drainage. Final Considerations: Pediatric brain abscess is an uncommon disease, still with high morbidity and mortality. Surgical drainage or excision of pediatric abscesses remains the basis of treatment both to relieve the mass effect and to provide a microbiological diagnosis. The literature demonstrates that broad-spectrum antibiotics and access to CT and MRI images decrease the rates of morbidity and mortality. It is concluded that the therapeutic approach involves the administration of broad-spectrum intravenous antibiotics and surgical drainage in more complex cases.

Sign in / Sign up

Export Citation Format

Share Document