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Z Orthop Unfall. 2013 Aug;151(4):338-42. doi: 10.1055/s-0032-1328665. Epub 2013 Jul 1.

[Influence of comorbidities and delay in surgical treatment on mortality following femoral neck fracture].

[Article in German]

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1
Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Aachen.

Abstract

BACKGROUND:

Hip fractures typically occur in geriatric patients representing an increasing medical as well as socioeconomic challenge.

PATIENTS AND METHODS:

In order to reveal the influence of considerable comorbidities and the time of surgery in the treatment of geriatric hip fractures we analysed patients treated between 1993 and 2008 at a level I trauma centre.

RESULTS:

654 patients with isolated hip fractures were included. Surgical treatment was performed with osteosynthetic stabilisation in 55.5 % (n = 363) and with endoprosthetic implants in 44.5 % (n = 291). The presence of pulmonary, psychiatric and metabolic/endocrinological comorbidities resulted in delayed treatment. If an early surgical treatment was performed within the first 12 hours after hospital admission, long-term survival was significantly improved (p = 0.02). A regression analysis revealed a statistical trend towards an increased mortality of 0.2 % per hour delay after hospital admission. The presence of considerable comorbidities and surgical treatment with endoprosthetic implants (odds ratio 1.611) were proven as independent mortality factors.

CONCLUSION:

The present study supports the guideline of early surgical treatment of geriatric hip fractures. Emphasising the incidence of in-hospital complications and the mortality after endoprosthetic treatment, osteosynthetic fracture stabilisation should be considered in the presence of considerable morbidity and pre-surgical immobilisation.

PMID:
23817802
DOI:
10.1055/s-0032-1328665
[Indexed for MEDLINE]
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