Hip # Outcome Predictors - Pete Thompson 16/8/2000

Outcome post hip fracture is a difficult 'measurement' and predicting outcome even more difficult due to the complex interaction of a huge number of factors including pt. mix, co-morbidities, treatment, timing of treatment pre- and postoperative care. This is reflected in the fairly wide range of mortality reported.

Age and cognitive ability are the two most important predictive factors of survival followed by co-morbidities (1,2) but these factors are not entirely independent of each other. Operative delay in medically unfit pts is actually associated with increased survival but delay in fit patients should be avoided (1). Postoperatively poor mobility and post-op complications correlate with higher mortality rates.

Having some idea of likely outcome is helpful in identifying 'at-risk' groups. The Functional Recovery Score (3,4) may become a commonly used outcome score for assessment of such pts and to help compare grps of pts in future studies.

1

Authors

  S.B. Sexton and J.T. Lehner

Title

Factors Affecting Hip Fracture Mortality

Reference

Journal of Orthopaedic Trauma Vol. 1, No. 4 (1988) 298-305

Summary

Increased mortality is associated with age, mental state, mobility on discharge, pre-op. co-morbidities and development of post-op complications. Operative delay in healthy individuals increases mortality but has no significant effect in medically fit patients.

Critique

Retrospective review of heterogeneous group of 300 hip # pts.

2

Authors

G.K. Ions and J. Stevens

Title

Prediction Of Survival In Patients With Femoral Neck Fractures.

Reference

J.B.J.S. 69-B (3) (1987) 384-387

Summary

Mental test score, age, CVA and malignancy correlated best with mortality. Injury outside of the home and ability to carryout own shopping correlate with increased survival. Chest infection is commonest cause of death.

Critique

Prospective study with strict protocol and only one operating surgeon. Reasonable nos. and sensible conclusions.



Please log in to view the content of this page.
If you are having problems logging in, please refer to the login help page.


© 2011 Orthoteers.co.uk Website by Regency Medical Marketing 
Biomet supporting orthoteersOrthoteers is a non-profit educational resource. Click here for more details
Epidemiology of Hip Fractures - Man...
Extracapsular Hip #s: Operative Man...
Hip # Outcome Predictors - Pete Tho...
Hip Fracture Classification - Ian M...
Hip Fracture: Non-operative Mx - Ca...
Intertochanteric Hip Fractures - 16...
Intracapsular Hip #s: Operative man...
OWLS Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search
Hide Menu