The mortality rate after thromboembolism prophylaxis in the hip fracture surgery

Abstract

Background: Although hip fracture surgery treatments have been improved, the mortality rate remains high because of a high risk of complications, such as myocardial infarction and venous thromboembolism. Many studies have identified the benefit of thromboembolism prophylaxis.

Objective: To determine the 1-year mortality rate of thromboembolism prophylaxis and non-prophylaxis after the hip fracture surgery.

Material and method: This study is a prospective analytic study. 114 patients who had undergone the hip fracture surgery between 2004-05 were given follow-up examinations every 3 months for 1 year.

Results: Of the 114 patients, 25 patients (21.9%) have received the medical thromboprophylactic protocol and 89 patients (78.1%) have not. The 1-year mortality rate was 12.0% (3 cases) and 9.0% (8 cases) in the thromboprophylactic group and nonprophylactic group, respectively (p = 0.704). The mean age was significantly older in the deceased group (86.4 year old, SD 12.86) than the non-deceased group (78.0 years old, SD 8.04) (p = 0.003). The median duration from postoperation to death was 19 weeks after the surgery (range 0.5- 52 weeks). The causes of death were acute myocardial infarction 3 (27.3%), sepsis 2 (18.2%), aspiration pneumonia 1 (9.1%), and unknown cause 5 (45.4%).

Conclusion: The overall 1 year mortality rate after surgery of the hip fracture is 9.6% and it is not different regardless of whether the medical thromboembolism prophylaxis has been established or not. Myocardial infarction was the most common cause (273%). The elderly patient is at a higher risk of mortality in 1 year after the surgery.