The Analysis of Postoperative Mortality after Bipolar Hemiarthroplasty for Hip Fractures in the Elderly

Dukhwan Kho; Kyoungmo Nam; Sunghak Oh; Hyeungjune Kim

doi:10.5371/hp.2013.25.4.267

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Kho, Nam, Oh, and Kim: The Analysis of Postoperative Mortality after Bipolar Hemiarthroplasty for Hip Fractures in the Elderly

Original Article

Hip & Pelvis 2013; 25(4): 267-273.

Published online: 31 December 2013

DOI: https://doi.org/10.5371/hp.2013.25.4.267

The Analysis of Postoperative Mortality after Bipolar Hemiarthroplasty for Hip Fractures in the Elderly

Dukhwan Kho, MD, Kyoungmo Nam, MD, Sunghak Oh, MD, Hyeungjune Kim, MD

Department of Orthopedic Surgery, Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.

Address reprint request to Hyeungjune Kim, MD. Department of Orthopedic Surgery, Konkuk University School of Medicine, 620-5 Gyohyun-dong, Chungju 380-704, Korea. TEL: +82-43-840-8250, FAX: +82-43-844-7300, hjune7610@naver.com

Received 29 March 2013 Revised 2 October 2013 Accepted 10 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study evaluated the rate of mortality and analyzed the associated risk factors in elderly patients treated with bipolar hemiarthroplaty for the hip fractures.

Materials and Methods

Between March 1994 and March 2010, the clinical records of 246 patients(278 cases) older than 75 years of age who underwent bipolar hemiarthroplaty after hip fractures were reviewed. The mean age of the subjects was 83.7 years(75-103 years). The relationship between the postoperative one year mortality and the related factors (age, gender, type of hip fractures, the timing of surgery, the associated medical condition, ASA grade, osteoporosis, walking ability and residence type) were analyzed. The subjects were divided into the dead group and survivor group.

Results

The mean postoperative mortality rate within 1 year was 17.2%(48 cases). The highest mortality rate was observed at postoperative 3 months(9.7%, 27 cases), followed in order by between 4 and 6 months(5.4%, 15 cases) and 7 and 12 months(2.1%, 6 cases). The postoperative mortality rate within 1 year was affected by the timing of the operation, ASA grade, patient's walking ability, and residence type, but there were no significant difference of the other factors, such as age, gender, osteoporosis, and type of hip fractures.

Conclusion

The ASA grade, timing of the operation, walking ability, and residence type are factors associated with the mortality rate in elderly patients with hip fractures.

Keywords: Elderly, Hip fracture, Bipolar hemiarthroplasty, Mortality rate

Figures and Tables

Table 1

Mortality Rate for 12 Months

Table 2

Analysis of Various Factors on Postoperative Mortality

Table 3

Recovery of Walking Ability by Clawson's Ambulation Capacity Classification

Table 4

Type of Living Arrangement

References

1. Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip. J Bone Joint Surg Am. 1994; 76:751–758.

2. Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH. Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am. 1995; 77:1551–1556.

3. Singh M, Nagrath AR, Maini PS. Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am. 1970; 52:457–467.

4. Clawson DK. Intertrochanteric fracture of the hip. Am J Surg. 1957; 93:580–587.

5. Gingras MB, Clarke J, Evarts CM. Prosthetic replacement in femoral neck fractures. Clin Orthop Relat Res. 1980; (152):147–157.

6. Ihn JC, Kim PT, Park IH, Kim SY, Oh CW, KIM JH. Motality rate in older patients who have a hip fracture. J Korean Soc Fract. 1997; 10:1–7.

7. Chang JD, Yoo JH, Lee SS, Kim TY, Jung KH, Kim YK. Bipolar hemiarthroplasty for hip fractures in patients aged over 90 years: The factor influencing the postoperative mortality. J Korean Hip Soc. 2010; 22:283–290.

8. Kim DS, Shon HC, Kim YM, Choi ES, Park KJ, Im SH. Postoperative mortality and the associated factors for senile hip fracture patients. J Korean Orthop Assoc. 2008; 43:488–494.

9. Dahl E. Mortality and life expectancy after hip fractures. Acta Orthop Scand. 1980; 51:163–170.

10. Johnson JT, Crothers O. Nailing versus prostehsis for femoral-neck fractures. A critical review of long-term results in two hundred and thirty-nine consecutive private patients. J Bone Joint Surg Am. 1975; 57:686–692.

11. Fitts WT Jr, Lehr HB, Schor S, Roberts B. Life expectancy after fracture of the hip. Surg Gynecol Obstet. 1959; 108:7–12.

12. Yoon HK, Park C, Jang S, Jang S, Lee YK, Ha YC. Incidence and mortality following hip fracture in Korea. J Korean Med Sci. 2011; 26:1087–1092.

13. Kenzora JE, McCarthy RE, Lowell JD, Sledge CB. Hip fracture mortality. Relation to age, treatment, preoperative illness, time of surgery, and complication. Clin Orthop Relat Res. 1984; (186):45–56.

14. Eiskjaer S, Ostgård SE. Risk factors influencing mortality after bipolar hemiarthroplasty in the treatment of fracture of the femoral neck. Clin Orthop Relat Res. 1991; (270):295–300.

15. Choi JC, Na HY, Lee YS, et al. Mortality after treatment of hip fracture over 80 years old. J Korean Hip Soc. 2006; 18:116–120.

16. White BL, Fisher WD, Laurin CA. Rate of mortality for elderly patients after fracture of the hip in the 1980's. J Bone Joint Surg Am. 1987; 69:1335–1340.

17. Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology. 1978; 49:239–243.

18. Dolk T. Influence of treatment factors on the outcome after hip fractures. Ups J Med Sci. 1989; 94:209–221.

19. Egol KA, Strauss EJ. Perioperative considerations in geriatric patients with hip fracture: what is the evidence? J Orthop Trauma. 2009; 23:386–394.

20. Bae IT, Lee WS, Kim SB, Heo YM, Park CY. Postoperative complications of hip fractures in patients with chronic kidney disease. J Korean Hip Soc. 2009; 21:169–173.

21. Kim BH, Chung YY, Ki SC, Yoon DH, Ryu JH. Cementless bipolar hemiarthroplasty for unstable intertrochanteic fractures in the elderly. J Korean Orthop Assoc. 2011; 46:399–404.

22. Dharmarajan TS, Tankala H, Patel B, Sipalay M, Norkus EP. Outcome in ambulatory status immediately following hip fracture surgery in the acute setting: a comparison of nursing home residents and community older adults. J Am Med Dir Assoc. 2001; 2:115–119.

23. Kim SW, Yang YJ, Eo KS, Cho HJ, Kim YS. Fear of falling in elderly persons living in a home for the aged. J Korean Acad Fam Med. 1998; 19:1400–1409.

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