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Predictors of Prognosis for Elderly Patients with Poststroke Hemiplegia Experiencing Hip Fractures

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Clinical Orthopaedics and Related Research®

Abstract

Hip fracture is an important cause of mortality and disability in elderly patients, particularly in those with poststroke hemiplegia, but little information is available regarding differences of general characteristics between patients with and without hemiplegia who experience hip fractures, factors predicting recovery of prefracture ambulatory status, and mortality of patients with poststroke hemiplegia with hip fractures. We retrospectively reviewed 1379 consecutive prospectively followed patients with hip fractures treated from January 2000 to May 2006. Of the 1379 patients, 101 (7.3%) had poststroke hemiplegia. All patients were followed a minimum of 1 year if they survived more than a year or until death if they died within a year after surgery (mean, 19.5 months; range, 4–49 months). According to the American Society of Anesthesiologists (ASA) rating, the patients with hemiplegia were sicker than patients without hemiplegia, more likely to have three or more comorbidities, lower cognitive ability, weaker prefracture ambulatory status, more days of hospitalization, and higher mortality rate. Gender, ASA rating, number of comorbidities, and prefracture ambulatory status predicted mortality of hip fractures in elderly patients with poststroke hemiplegia, and the ASA rating, number of comorbidities, and cognitive ability predicted recovery of prefracture ambulatory status for these patients.

Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Sun Fei and Zhu Yan (statistical experts) for invaluable statistical advice; Tan Jing, MD, and Alexi for helpful comments on the manuscripts; Dr Nie Qingbing for collecting documents; and Editor-in-Chief, Dick Brand, and editorial assistant, Ryan Krausmann, for invaluable remarks and instructions.

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Authors and Affiliations

  1. Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Mingli Feng MD, Huiliang Shen, Huaijian Hu MD & Li Cao

  2. Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Changchun Ave 45, Xuanwu District, Beijing, 100053, China

    Jian Zhang MD

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  1. Mingli Feng MD
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  2. Jian Zhang MD
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  3. Huiliang Shen
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  4. Huaijian Hu MD
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Correspondence to Jian Zhang MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Feng, M., Zhang, J., Shen, H. et al. Predictors of Prognosis for Elderly Patients with Poststroke Hemiplegia Experiencing Hip Fractures. Clin Orthop Relat Res 467, 2970–2978 (2009). https://doi.org/10.1007/s11999-009-0835-5

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  • DOI: https://doi.org/10.1007/s11999-009-0835-5

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