International Orthopaedics

, Volume 18, Issue 2, pp 109–113 | Cite as

The mortality and social prognosis of hip fractures

A prospective multifactorial study
  • R. P. Pitto
Article

Summary

A prospective 5-year study was carried out of 143 patients with trochanteric fractures treated by Ender nailing. A detailed proforma was used for multifactorial analysis in order to identify the prognostic indicators of social function and quality of life of the patients. Their mean age was 81 years and the female: male ratio 7∶1. The mortality rate 6 months after injury was 23%, and at the end of 5 years 45.5%. The patients surviving the first 6 months had the same life expectancy as the general population. Dementia, associated disease, medical complications, total dependency and age were the most significant predictors of mortality. These factors, with pressure sores and poor rehabilitation, were also significant in determining the prognosis of social function. Deterioration of health status was seen in 36% during the first 6 months after injury and 40% showed deterioration of their social condition within this period. Later, most survivors recovered and were restored to their previous state. Postoperative geriatric care is essential to achieve this aim.

Résumé

L'auteur présente une étude prospective, s'étendant sur 5 ans, et portant sur 143 patients atteints de fractures trochantériennes traitées par ostéosynthèse par clous de Ender. Un dossier détaillé a été utilisé en vue d'une analyse multifactorielle pour préciser le pronostic vital et fonctionnel. L'âge moyen du groupe était de 81 ans, avec des extrêmes de 60 à 100 ans, et le rapport femme/homme était de 7/1. Le taux de mortalité s'élevait à 23% six mois après la fracture et à 45.5% après 5 ans. Les patients survivant les six premiers mois ne présentaient pas un taux de mortalité excessif pendant la période d'observation et ils avaient la même espérance de vie que la population générale. La démence, les maladies associées, les complications médicales, la dépendance totale du patient et l'âge étaient les signes prédictifs les plus fiables de la mortalité. Une aggravation de l'état de santé a été observée chez 36% des patients survivants au cours des six premiers mois suivant l'accident. Les maladies associées, la démence, les escarres et un programme de rééducation insuffisant étaient les facteurs les plus significatifs du pronostic fonctionnel. Durant les six premiers mois suivant la fracture, 40% des patients survivants présentaient une détérioration de leur vie sociale. L'aggravation de l'état de santé et de l'état fonctionnel a cependant été limitée à cette période aiguë, suivant l'accident; ensuite la plupart des patients survivants ont pu recouvrer leurs conditions préalables. Ces résultats soulignent l'importance des soins gériatriques post-opératoires pour prévenir les conséquences défavorables de la fracture et ramener le patient à son état antérieur.

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • R. P. Pitto
    • 1
  1. 1.I Clinica OrtopedicaUniversitá di FirenzeItalia

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