Hip fracture treatment: outcome and socio-economic aspects. A one-year survey in a Belgian University Hospital

Abstract

Between October 1, 1997 and September 30, 1998, 201 consecutive hip fractures in patients over the age of 50 were registered according to the SAHFE (Standardised Audit of Hip Fractures in Europe) protocol. The mean age was 81.3 years; 75% were females, more than 40% were admitted from an institution and fewer than 10% were completely fit. Almost 60% of the fractures occurred in the trochanteric region while less than 40% were intracapsular. All fractures but one were operated on, according to a standardised protocol. More than half the patients were treated with a dynamic hip screw, more than 30% with a cemented biarticulated hemiarthroplasty and fewer than 15% with cannulated screws. The mean admission time in the orthopedic department was 18.7 days and was poorly correlated with the type of surgery or with the place to which the patients were discharged. After hospitalisation, most patients admitted from an institution went back to that institution. More than one-third of the patients admitted from their home went back home but over 40% used rehabilitation facilities. After four months, 32 patients had died, 27 were lost to follow-up and six had been reoperated. Of the independent patients, at least 24% were institutionalised and more than 60% lived at home. Although hip fractures in the elderly are expensive and debilitating, adequate operative treatment and rehabilitation can reduce costs by limiting the hospital stay, lowering reoperation rates and by favouring reintegration into their prefracture surroundings.