Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -

Jun-Dong Chang; Je-Hyun Yoo; Sang-Soo Lee; Tae-Young Kim; Kyu-Hak Jung; Yong-Kuk Kim

doi:10.5371/jkhs.2010.22.4.283

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Chang, Yoo, Lee, Kim, Jung, and Kim: Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(4): 283-290.

Published online: 31 December 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.4.283

Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -

Jun-Dong Chang, MD, Je-Hyun Yoo, MD, Sang-Soo Lee, MD, Tae-Young Kim, MD, Kyu-Hak Jung, MD, Yong-Kuk Kim, MD

Department of Orthopedic Surgery, College of Medicine, Hallym University, Seoul, Korea.

Address reprint request to Je-Hyun Yoo, MD. Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, 896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, Korea. TEL: +82-31-380-3770, FAX: +82-31-382-1814, oships@hallym.ac.kr

Received 13 August 2010 Revised 9 November 2010 Accepted 10 November 2010

Abstract

Purpose

We wanted to evaluate the factors that influence the one-year mortality rate after bipolar hemiarthroplasty in elderly patients over 90 years of age and who had hip fractures.

Materials and Methods

In this retrospective study, we enrolled 42 cases (29 females and 12 males) that were treated by bipolar hemiarthroplasty for hip fractures between April 1999 and April 2008. The mean age was 94 (range: 90~101) years. We compared such variables as age, gender, BMD (bone mineral density), the ASA (American Society of Anesthesiologists) score, the type of fracture, the operation time, the type of anesthesia, the length of the ICU (intensive care unit) care, the length of hospitalization, operative delay and the postoperative ambulatory capability between the one-year mortality group and the control group (alive over a minimum of 1-year), and we investigated the risk factors related to one-year mortality.

Results

The one-year mortality rate was 32%. There were significant relationships between the postoperative one-year mortality and the ASA score, the length of the ICU care, operative delay and the postoperative ambulatory capability. The one-year mortality rate in the trochanteric fracture group was significantly higher than that in the neck fracture group. However, there were no relationships between the one-year mortality and age, gender, BMD, the length of operation, the type of anesthesia and the length of the hospitalization.

Conclusion

The preoperative ASA score was significantly higher in the one-year mortality group among the elderly patients over 90 years of age and who were treated with bipolar hemiarthroplasty for hip fractures. The length of the ICU care, operative delay and the postoperative ambulatory capability were significantly associated with one-year mortality, and so all of these should be considered as postoperative prognostic factors.

Keywords: Hip fracture, Hemiarthroplasty, One-year mortality, Elderly over 90

Figures and Tables

Fig. 1

Kaplan-Meier survival curve of patients following treatment hip fractures in nonagenarians.

Fig. 2

Postoperative walking status of nonagenarians with hip fracture.

Table 1

Preoperative Baseline Data of Nonagenarians with Hip Fracture (n=42)

Table 2

Comparative Results at 1-Year Control between Dead and Alive Patients

^*NS; not significant

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