title: Outcome after surgery for fracture of the hip in patients aged over 95 years.
abstract: Despite the increase in numbers of the extreme elderly, little data is available regarding their outcome after surgery for fracture of the hip. We performed a prospective study of 50 patients aged 95 years and over who underwent this procedure. Outcome measures included morbidity, mortality, hospital stay, residential and walking status. Comparison was made with a control group of 200 consecutive patients aged less than 95 years who had a similar operation. The mortality at 28 and 120 days was higher (p = 0.005, p = 0.001) in the patients over 95 years. However, the one-year cumulative post-operative mortality was neither significantly different between the two groups (p = 0.229) nor from the standardised mortality rate for the age-matched population (p = 0.445). Predictors of mortality included the ASA grade, the number of comorbid medical conditions and active medical problems on admission. Patients over 95 were unlikely to recover their independence and at a mean follow-up of 29.3 months (12.1 to 48) 96% required permanent institutional care.
authors.affiliation: Department of Trauma and Orthopaedics, Western Infirmary, Glasgow, UK. graemeholt@btinternet.com
authors.forename: G
authors.initials: G
authors.lastname: Holt
authors.forename: D
authors.initials: D
authors.lastname: Macdonald
authors.forename: M
authors.initials: M
authors.lastname: Fraser
authors.forename: A T
authors.initials: AT
authors.lastname: Reece
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D011446:Prospective Studies; D012111:Residence Characteristics; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology