Predicting in-hospital mortality after hip fracture in elderly patients.
Ninety-seven patients aged 88 +/- 4 years (range, 80-97 years) (study group), and 74 aged 75 +/- 3 years (range, 70-79 years) (control group), were prospectively studied to investigate whether basic medical variables can predict in-hospital mortality in very old patients undergoing hip surgery because of femoral fracture. Mortality was 16.5% and 6.7% in the study and control groups, respectively (p = 0.054). In the study group, mortality was significantly correlated with age (p < 0.01), venous disorders (p < 0.05), malnutrition (p < 0.0001), duration of surgery (p < 0.006), and postoperative noninfectious complications (p < 0.005). In the control group, age was the only significant correlate of mortality (p < 0.005). After exclusion of surgery-related variables, the logistic regression analysis confirmed the predictive role of venous disorders (odds ratio = 2.04, confidence limits = 1.09-3.79) and malnutrition (odds ratio = 6.01, confidence limits = 1.85-19.47) but not of age in the study group. However, the goodness-of-fit test showed that the statistical model did not fit the data adequately. We conclude that in-hospital mortality after hip surgery in the very old cannot be predicted on the basis of underlying medical conditions alone.
Incalzi
R A
RA
Dept. of Geriatrics, Catholic University of the Sacred Heart, Roma, Italy.
Capparella
O
O
Gemma
A
A
Camaioni
D
D
Sanguinetti
C
C
Carbonin
P U
PU
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000401:mortality* / Q000601:surgery; D005544:Forecasting; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009748:Nutrition Disorders / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014652:Vascular Diseases / Q000150:complications / Q000453:epidemiology