The mortality rate after thromboembolism prophylaxis in the hip fracture surgery.
BACKGROUND
Although hip fracture surgery treatments have been improved, the mortality rate remains high because of a high risk of complications, such as myocardial infarction and venous thromboembolism. Many studies have identified the benefit of thromboembolism prophylaxis.


OBJECTIVE
To determine the 1-year mortality rate of thromboembolism prophylaxis and non-prophylaxis after the hip fracture surgery.


METHODS
This study is a prospective analytic study. 114 patients who had undergone the hip fracture surgery between 2004-05 were given follow-up examinations every 3 months for 1 year.


RESULTS
Of the 114 patients, 25 patients (21.9%) have received the medical thromboprophylactic protocol and 89 patients (78.1%) have not. The 1-year mortality rate was 12.0% (3 cases) and 9.0% (8 cases) in the thromboprophylactic group and nonprophylactic group, respectively (p = 0.704). The mean age was significantly older in the deceased group (86.4 year old, SD 12.86) than the non-deceased group (78.0 years old, SD 8.04) (p = 0.003). The median duration from postoperation to death was 19 weeks after the surgery (range 0.5- 52 weeks). The causes of death were acute myocardial infarction 3 (27.3%), sepsis 2 (18.2%), aspiration pneumonia 1 (9.1%), and unknown cause 5 (45.4%).


CONCLUSIONS
The overall 1 year mortality rate after surgery of the hip fracture is 9.6% and it is not different regardless of whether the medical thromboembolism prophylaxis has been established or not. Myocardial infarction was the most common cause (273%). The elderly patient is at a higher risk of mortality in 1 year after the surgery.
Chotanaphuti
Thanainit
T
Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand.
Jareonarpornwatana
Aekachai
A
Laoruengthana
Artit
A
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016019:Survival Analysis; D013923:Thromboembolism / Q000150:complications / Q000401:mortality / Q000517:prevention & control*
D000925:Anticoagulants; D005343:Fibrinolytic Agents