PMID- 28678129
DCOM- 20170825
LR  - 20170825
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 13
DP  - 2017 Jul 5
TI  - Short-Term Outcomes Following Hip Fractures in Patients at Least 100 Years Old.
PG  - e68
LID - 10.2106/JBJS.16.00697 [doi]
AB  - BACKGROUND: The number of hip fractures is rising as life expectancy increases.
      As such, the number of centenarians sustaining these fractures is also
      increasing. The purpose of this study was to determine whether patients who are
      >/=100 years old and sustain a hip fracture fare worse in the hospital than those
      who are younger. METHODS: Using a large database, the New York Statewide Planning
      and Research Cooperative System (SPARCS), we identified patients who were >/=65
      years old and had been treated for a hip fracture over a 12-year period. Data on 
      demographics, comorbidities, and treatment were collected. Three cohorts were
      established: patients who were 65 to 80 years old, 81 to 99 years old, and >/=100
      years old (centenarians). Outcome measures included hospital length of stay,
      estimated total costs, and in-hospital mortality rates. RESULTS: A total of
      168,087 patients with a hip fracture were identified, and 1,150 (0.7%) of them
      had sustained the fracture when they were >/=100 years old. Centenarians incurred
      costs and had lengths of stay that were similar to those of younger patients.
      Despite the similarities, centenarians were found to have a significantly higher 
      in-hospital mortality rate than the younger populations (7.4% compared with 4.4% 
      for those 81 to 99 years old and 2.6% for those 65 to 80 years old; p < 0.01).
      Male sex and an increasing number of medical comorbidities were found to predict 
      in-hospital mortality for centenarians sustaining extracapsular hip fractures. No
      significant predictors of in-hospital mortality were identified for centenarians 
      who sustained femoral neck fractures. An increased time to surgery did not
      influence the odds of in-hospital mortality. CONCLUSIONS: Centenarians had
      increased in-hospital mortality, but the remaining short-term outcomes were
      comparable with those for the younger cohorts with similar fracture patterns. For
      this extremely elderly population, time to surgery does not appear to affect
      short-term mortality rates, suggesting a potential benefit to preoperative
      optimization. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for
      Authors for a complete description of levels of evidence.
FAU - Manoli, Arthur 3rd
AU  - Manoli A 3rd
AD  - 1New York University Hospital for Joint Diseases, New York, NY.
FAU - Driesman, Adam
AU  - Driesman A
FAU - Marwin, Rebecca A
AU  - Marwin RA
FAU - Konda, Sanjit
AU  - Konda S
FAU - Leucht, Philipp
AU  - Leucht P
FAU - Egol, Kenneth A
AU  - Egol KA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Female
MH  - Hip Fractures/economics/mortality/*surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - New York
MH  - Treatment Outcome
EDAT- 2017/07/06 06:00
MHDA- 2017/08/26 06:00
CRDT- 2017/07/06 06:00
PHST- 2017/07/06 06:00 [entrez]
PHST- 2017/07/06 06:00 [pubmed]
PHST- 2017/08/26 06:00 [medline]
AID - 10.2106/JBJS.16.00697 [doi]
AID - 00004623-201707050-00011 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Jul 5;99(13):e68. doi: 10.2106/JBJS.16.00697.