Co-morbidities, complications and causes of death among people with femoral neck fracture - a three-year follow-up study.
BACKGROUND
The poor outcome after a hip fracture is not fully understood. The aim of the study was to describe the prevalence of co-morbidities, complications and causes of death and to investigate factors that are able to predict mortality in old people with femoral neck fracture.


METHODS
Data was obtained from a randomized, controlled trial with a 3-year follow-up at Umeå University Hospital, Sweden, which included 199 consecutive patients with femoral neck fracture, aged ≥70 years. The participants were assessed during hospitalization and in their homes 4, 12 and 36 months after surgery. Medical records and death certificates were analysed.


RESULTS
Multivariate analysis revealed that cancer, dependence in P-ADL (Personal Activities of Daily Living), cardiovascular disease, dementia at baseline or pulmonary emboli or cardiac failure during hospitalization were all independent predictors of 3-year mortality. Seventy-nine out of 199 participants (40 %) died within 3 years. Cardiovascular events (24 %), dementia (23 %), hip-fracture (19 %) and cancer (13 %) were the most common primary causes of death. In total, 136 participants suffered at least one urinary tract infection; 114 suffered 542 falls and 37 sustained 56 new fractures, including 13 hip fractures, during follow-up.


CONCLUSIONS
Old people with femoral neck fracture have multiple co-morbidities and suffer numerous complications. Thus randomized intervention studies should focus on prevention of complications that might be avoidable such as infections, heart diseases, falls and fractures.
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden. monica.langstrom@umu.se.
Monica
M
Berggren
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden.
Michael
M
Stenvall
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden.
Undis
U
Englund
Department of Surgical and Perioperative Sciences, Orthopaedics, Umeå University, SE-901 87, Umeå, Sweden.|Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
Birgitta
B
Olofsson
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden.
Yngve
Y
Gustafson
D000058:Accidental Falls / Q000401:mortality; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D015897:Comorbidity; D003704:Dementia / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D006760:Hospitalization / Q000639:trends; D006785:Hospitals, University / Q000639:trends; D006801:Humans; D008297:Male; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
Cause of death; Complications; Hip fracture