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. 2021 Nov;15(3):21-28.
doi: 10.5704/MOJ.2111.004.

Outcomes in Nonagenarians with Hip Fractures Treated Conservatively and Surgically

R Malhotra  1 , S S Huq  1 , M Chong  1 , D Murphy  1 , Z J Daruwalla  1
Affiliations

Outcomes in Nonagenarians with Hip Fractures Treated Conservatively and Surgically

R Malhotra et al. Malays Orthop J. 2021 Nov.

Abstract

Introduction: We aimed to assess the clinical outcomes in nonagenarians following a hip fracture. We also further investigated the factors that influence these outcomes, such as method of treatment (operative versus conservative), co-morbidities, and pre-morbid function.

Materials and methods: We studied 65 nonagenarians that were identifiable from our hospital hip fracture database. We reviewed various parameters of these patients admitted after sustaining a hip fracture (neck of femur or intertrochanteric) and investigated how these parameters affected patient outcomes. The main outcomes studied were: inpatient morbidity, and mortality at one year.

Results: Inpatient morbidity was more likely in patients with an ASA grade of 3 to 5. Urinary tract infection was the most common medical complication. The 1-year mortality was 15.4% and was significantly influenced by advancing age. Surgically managed patients had a 1-year mortality rate (14.3%) slightly less than non-operative patients (17.4%). Post injury mobility was significantly better in those who received operative treatment with 63% of surgical cases regaining ambulatory status versus 7% of conservatively managed patients.

Conclusions: We presented the outcomes of hip fractures in an extreme age group in the population. In nonagenarians with hip fractures surgery was associated with a 1-year mortality rate of 14.3% which is comparable to the general hip fracture population and less than the mortality rate of conservatively managed patients (17.4%). The primary advantage of surgery would be that two-thirds of patients return to ambulatory status. This information is useful to counsel patients and their families especially since the elderly are often more fearful of surgical intervention.

Keywords: hip fracture; mobility; morbidity; mortality; nonagenarians.

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References

    1. Recommendations for preventing osteoporosis http://www.who.int/dietphysicalactivity/publications/trs916/en/gsfao_ost... Health Organization. (assessed on 28 November 2013)
    1. Department of Statistics, Republic of Singapore. Population Trends 2013. 2013 (assessed on 28 November 2013)
    1. Ministry of Social and Family Development S. Brief on Ageing Population in Singapore http://app.msf.gov.sg/Portals/0/Topic/Issues/EDGD/Brief%20on%20Ageing%20... (assessed on 28 November 2013)
    1. Dahl E.. Mortality and life expectancy after hip fractures. Acta Orthop Scand. 1980;51(1):163–70. - PubMed
    1. Parker MJ, Handoll HH, Bhargara A. Conservative versus operative treatment for hip fractures. Cochrane Database Syst Rev. 2000. (4): CD000337. - PubMed

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