title: One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment.
abstract: OBJECTIVE
  Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU) treatment, including invasive ventilatory management (IVM) and hemodiafiltration (CVVHDF), is sparse.
  
  
  METHODS
  Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA) classification, and the Barthel index (BI) were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care.
  
  
  RESULTS
  15% were treated > 3 days and 68% < 3 days in ICU. Both cohorts had similar ASA, BI, and age. In-hospital, 6-month, and 12-month mortality of ICU > 3d cohort were significantly increased (p = 0.001). Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort.
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Daphne
authors.initials: D
authors.lastname: Eschbach
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bliemel
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Oberkircher
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Rene
authors.initials: R
authors.lastname: Aigner
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Juliana
authors.initials: J
authors.lastname: Hack
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bockmann
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Ruchholtz
authors.affiliation: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Buecking
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000503:physiopathology*; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors