title: Further experience of nonagenarians with hip fractures.
abstract: Our purpose was to investigate the factors after predictive outcome 3 months after the injury in terms of mortality and effective independent walking of nonagenarians with hip fracture. A prospective study was carried out for 2 yr in the orthopaedic wards on patients referred to geriatricians. The data were subjected to logistic regression forward stepwise analysis. Eighty-nine patients were included in the study; 55 (61.8%) had a trochanteric fracture and 86 required a surgical procedure. Before the fracture, 83 patients (93.3%) were able to walk by themselves or with minimal supervision. Forty-three patients (48.3%) had an American Society of Anaesthesiologists' of III-IV score. The mean number of postoperative complications was four. Mean hospital stay was 18.2 days. Within 3 months, 19 patients (21.3%) had died and 58 (69%) were living in their previous residence. Thirty-three (50% of living patients) were able to walk by themselves or with minimal help within 3 months of the fracture. Predictive variables for 3-month mortality were pre-fracture dependence on others for personal toilet and the presence of cognitive impairment. Predictive variables for independent efficient walking were bowel control and absence of cognitive impairment before the fracture, as well as no development of bed sores during hospitalization.These nonagenarian patients with hip fractures show low perioperative mortality, frequently return to their previous accommodation and present a limited recovery of walking ability.
authors.affiliation: Geriatric Assessment Team, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain. talarcon1@yahoo.com
authors.forename: T
authors.initials: T
authors.lastname: Alarcón
authors.forename: J I
authors.initials: JI
authors.lastname: González-Montalvo
authors.forename: A
authors.initials: A
authors.lastname: Bárcena
authors.forename: P
authors.initials: P
authors.lastname: Saez
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000401:mortality; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000534:rehabilitation*; D016852:Housing for the Elderly; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D016138:Walking