Assessment of Mortality Risk in Elderly Patients After Proximal Femoral Fracture

Orthopedics ◽  
2014 ◽  
Vol 37 (2) ◽  
pp. e194-e200 ◽  
Author(s):  
Jennifer M.T.A. Meessen ◽  
Salvatore Pisani ◽  
Maria L. Gambino ◽  
Domenico Bonarrigo ◽  
Natasja M. van Schoor ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Mortality Risk ◽  
Femoral Fracture ◽  
Proximal Femoral Fracture

scholarly journals The Prognostic Value of Metabolic Profiling in Older Patients With a Proximal Femoral Fracture

2020 ◽  
Vol 11 ◽  
pp. 215145932096009
Author(s):  
Max P.L. van der Sijp ◽  
H. Eka D. Suchiman ◽  
Monica Eijk ◽  
Dina Vojinovic ◽  
Arthur H. P. Niggebrugge ◽  
...  
Keyword(s):  
Risk Score ◽  
Functional Recovery ◽  
Mortality Risk ◽  
Femoral Fracture ◽  
Patient Population ◽  
Prediction Accuracy ◽  
Prognostic Value ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Proximal Femoral Fractures

Introduction: High mortality rates of approximately 20% within 1 year after treatment are observed for patients with proximal femoral fractures. This preliminary study explores the prognostic value of a previously constructed mortality risk score based on a set of 14 metabolites for the survival and functional recovery in patients with proximal femoral fractures. Materials and Methods: A prospective observational cohort study was conducted including patients admitted with a proximal femoral fracture. The primary outcome was patient survival, and the recovery of independence in activities of daily living was included as a secondary outcome. The mortality risk score was constructed for each patient and its prognostic value was tested for the whole population. Results: Data was available form 136 patients. The mean age of all patients was 82.1 years, with a median follow-up of 6 months. Within this period, 19.0% of all patients died and 51.1% recovered to their prefracture level of independence. The mortality score was significantly associated with mortality (HR, 2.74; 95% CI, 1.61-4.66; P < 0.001), but showed only a fair prediction accuracy (AUC = 0.68) and a borderline significant comparison of the mortality score tertile groups in survival analyses (P = 0.049). No decisive associations were found in any of the analyses for the functional recovery of patients. Discussion: These findings support the previously determined prognostic value of the mortality risk score. However, the independent prognostic value when adjusted for potential confounding factors is yet to be assessed. Also, a risk score constructed for this specific patient population might achieve higher accuracies for the prediction of survival and functional recovery. Conclusions: A modest prediction accuracy was observed for the mortality risk score in this population. More elaborate studies are needed to validate these findings and develop a tailored model for clinical purposes in this patient population.

scholarly journals Perioperative pain management in elderly patients with а proximal femoral fracture: evidence review

Pain medicine ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 42-49
Author(s):  
Anastasiia Romanenko ◽  
Юрій Кучин ◽  
Катерина Бєлка ◽  
Ігор Токар
Keyword(s):  
Hip Fracture ◽  
Pain Management ◽  
Elderly Patients ◽  
Femoral Fracture ◽  
Adverse Drug Events ◽  
Perioperative Period ◽  
The Elderly ◽  
Proximal Femoral Fracture ◽  
Nerve Blocks ◽  
Number Of Patients

The purpose of this article is to compare different methods of analgesia during perioperative period in elderly patients with а proximal femoral fracture. The incidence of hip fracture is high and also rises with the age, for example, In Great Britain, number of patients with a hip fracture will be approximately 100 000 in 2033, and it’s also associated with significant healthcare financing. Nevertheless, effective pain management is a big challenge for clinicians because of considerable problems in geriatric patients, including age, physiological changes in the elderly, preexisting comorbidities, cognitive impairment, high risk of delirium, problems with rehabilitation and probability of an independent life [12].   Opioids are still the main option for hip fracture pain management, despite differences in pharmacokinetics and pharmacodynamics in elderly patients, which are correlated with high frequency of side effects. Opioid-related adverse drug events are associated with worse patient outcomes such as morbidity, mortality and length of stay increase. Therefore, peripheral nerve blocks as part of multimodal analgesic technique can provide more effective pain control after hip fracture. Comprehensive literature searches focus on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anesthesia for hip fracture surgery.

scholarly journals Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study

2017 ◽  
Vol 8 (4) ◽  
pp. 244-251 ◽  
Author(s):  
Ichiro Okano ◽  
Takatoshi Sawada ◽  
Nobumasa Kushima ◽  
Tetsuya Tachibana ◽  
Katsunori Inagaki
Keyword(s):  
Elderly Patients ◽  
Femoral Fracture ◽  
Proximal Femoral Fracture ◽  
Rotational Stability ◽  
Cephalomedullary Nail ◽  
Related Complication ◽  
Fracture Group ◽  
Helical Blade ◽  
Extracapsular Fracture

Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture. The aim of this study is to assess the effectiveness of helical blade CMN for basicervical fracture in elderly patients. Methods: We conducted a retrospective review of 500 consecutive extracapsular fracture patients treated surgically between January 2005 and February 2015. Patients who had trochanteric extension or multifragment fracture were excluded. Sixteen cases of 2-part basicervical proximal femoral fracture were identified. All patients were treated with the same single helical blade CMN system (DePuy Synthes PFNA-II). Implant-related complications were recorded. Results: Two patients dropped out during follow-up and 14 patients were included in the analysis. The average follow-up period was 21.9 months. No major complication was observed. The patients were subcategorized into 2 groups: nondisplaced (displacement <2 mm at any point of the fracture line) or displaced. Excessive telescoping was observed in 2 patients, both of whom were in the displaced fracture group. The overall implant-related complication rate was 14.2% (2/16). Conclusion: Internal fixation with the helical blade CMN system can be considered as a treatment option for 2-part basicervical proximal femoral fracture in elderly patients.

scholarly journals Elderly Patients with Proximal Femoral Fracture Who Returned to Living at Home with Their Spouse

2016 ◽  
Vol 65 (1) ◽  
pp. 9-14
Author(s):  
Koji SUZUKI ◽  
Sadaomi KAWACHI ◽  
Hideki NANKE ◽  
Hiromichi AOYAMA ◽  
Kei INOMATA ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Femoral Fracture ◽  
Proximal Femoral Fracture ◽  
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