In-hospital mortality analysis in patients with proximal femoral fracture operatively treated by hip arthroplasty procedure.
OBJECTIVE
Hip fracture remains the leading cause of death in trauma among elderly population and is a great burden to national health services. In-patient death analysis is important to evaluate risk factors, make appropriate selection and perform adequate treatment of infections for patients to be operated. The aim of this study was to analyze in-hospital mortality in proximal femoral fracture patients operatively treated with hip arthroplasty procedure.


METHODS
We followed 622 consecutive patients, and collected data about age, gender, the presence of infection preoperatively and postoperatively, American Society of Anesthesiologists (ASA) score, diabetes mellitus and the type of surgical procedure. Postoperative infections included pneumonia, urinary tract infections, surgical site infections and sepsis.


RESULTS
We found a statistically significant influence of preoperative and postoperative infection presence for in-patient mortality with relative risk for lethal outcome of 4.53 (95% CI: 1.44-14.22) for patients with preoperative infection and 7.5 (95% CI: 1.90-29.48) for patients with postoperative infection. We did not confirm a statistically significant influence of age, gender, ASA score, diabetes mellitus or the type of surgical procedure for increased mortality rate.


CONCLUSIONS
Adequate preoperative selection, risk evaluation and adequate treatment of infections are of the key importance for lowering the risk of death in patients operated due to proximal femoral fracture and treated by hip arthroplasty procedures. Special attention is to be paid for the presence of preoperative and postoperative infections in patients operatively treated due to the risk for increased in-hospital mortality.
Srdjan
S
Starcević
Vesna
V
Suljagić
Dusica
D
Stamenković
Dubravko
D
Bokonjić
Stasa
S
Munitlak
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality* / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000401:mortality*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality* / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality*; D057234:Preoperative Period; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000401:mortality*; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000401:mortality*