Predictors of prognosis for elderly patients with poststroke hemiplegia experiencing hip fractures.
Hip fracture is an important cause of mortality and disability in elderly patients, particularly in those with poststroke hemiplegia, but little information is available regarding differences of general characteristics between patients with and without hemiplegia who experience hip fractures, factors predicting recovery of prefracture ambulatory status, and mortality of patients with poststroke hemiplegia with hip fractures. We retrospectively reviewed 1379 consecutive prospectively followed patients with hip fractures treated from January 2000 to May 2006. Of the 1379 patients, 101 (7.3%) had poststroke hemiplegia. All patients were followed a minimum of 1 year if they survived more than a year or until death if they died within a year after surgery (mean, 19.5 months; range, 4-49 months). According to the American Society of Anesthesiologists (ASA) rating, the patients with hemiplegia were sicker than patients without hemiplegia, more likely to have three or more comorbidities, lower cognitive ability, weaker prefracture ambulatory status, more days of hospitalization, and higher mortality rate. Gender, ASA rating, number of comorbidities, and prefracture ambulatory status predicted mortality of hip fractures in elderly patients with poststroke hemiplegia, and the ASA rating, number of comorbidities, and cognitive ability predicted recovery of prefracture ambulatory status for these patients.


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Mingli
M
Feng
Jian
J
Zhang
Huiliang
H
Shen
Huaijian
H
Hu
Li
L
Cao
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D015577:Geriatric Assessment; D006429:Hemiplegia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D000071939:Stroke Rehabilitation; D016019:Survival Analysis; D016896:Treatment Outcome