title: Effect of mental state on mortality after hemiarthroplasty for fracture of the femoral neck. A retrospective study of 543 patients.
abstract: OBJECTIVE
  To assess mortality and functional results of Thompson's hemiarthroplasty for fractured neck of femur in patients with and without senile dementia.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  District hospital.
  
  
  METHODS
  543 Unselected patients who had intracapsular fractures of the femoral neck treated by hemiarthroplasty between 1979 and 1988.
  
  
  METHODS
  Mortality and functional results during a median follow up period of 14.9 months (range 0.0-111) for patients with senile dementia and 27.4 months (range 0.1-131) for patients who were not demented.
  
  
  RESULTS
  156 of 215 demented patients (73%) died during the follow up period compared with 169 of 328 of those who were not demented (52%). Of the 109 patients with dementia who were mobile before operation only 59 were mobile after operation (54%), compared with 199 of the 215 patients (93%) who were not demented (p < 0.001). Senile dementia seemed to be the only coexisting condition that had a significant effect on mortality.
  
  
  CONCLUSIONS
  Hemiarthroplasty is probably too major an operation with which to treat fractures of the femoral neck in demented patients.
authors.affiliation: Department of General Surgery, Sint Franciscus Hospital, Rotterdam, The Netherlands.
authors.forename: L M
authors.initials: LM
authors.lastname: van Dortmont
authors.forename: F C
authors.initials: FC
authors.lastname: Oner
authors.forename: J C
authors.initials: JC
authors.lastname: Wereldsma
authors.forename: P G
authors.initials: PG
authors.lastname: Mulder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000401:mortality*; D003704:Dementia / Q000150:complications; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D016743:Mental Competency; D012189:Retrospective Studies; D016896:Treatment Outcome