title: Operative outcome of Hong Kong centenarians with hip fracture.
abstract: BACKGROUND
  International clinical guidelines recommend early surgical treatment for geriatric patients with hip fracture. There are, however, few data concerning the operative outcome of centenarians. This study aimed to report the epidemiology of hip fracture and postoperative mortality rate, and to discuss whether operation is justified in centenarians in Hong Kong.
  
  
  METHODS
  This observational study was carried out in all public hospitals of Hong Kong. All patients aged 100 years or above who underwent hip fracture surgery in any public hospital between 1 January 2010 and 31 December 2013 were included. Their postoperative mean and median survival time was recorded.
  
  
  RESULTS
  Of 114 centenarians, 96 (84%) were female. The age of patients ranged from 100 to 109 years, with the largest number (44%) aged 100 years. The follow-up interval ranged from 5 to 1619 days (median, 412 days; interquartile range, 683 days). The 1-month, 6-month, and 1-year mortalities were 8%, 25%, and 37%, respectively. By Kaplan-Meier analysis, the postoperative mean survival was 2 years 2 months (95% confidence interval, 680-936 days) and the median survival time was 2 years (interquartile range, 1234 days).
  
  
  CONCLUSIONS
  The 1-year mortality among Hong Kong centenarians with hip fracture was 37%, which is lower than the 41.1% in the general centenarian population in Japan. The median survival time after hip fracture surgery was 2 years, suggesting that surgery even at an extreme age is worthwhile to maintain quality of life. Extreme age should not be a barrier to operative treatment.
authors.affiliation: Department of Orthopaedics and Traumatology, Caritas Medical Centre, Shamshuipo, Hong Kong.
authors.forename: M Y
authors.initials: MY
authors.lastname: Cheung
authors.affiliation: Department of Orthopaedics and Traumatology, Caritas Medical Centre, Shamshuipo, Hong Kong.
authors.forename: A Wh
authors.initials: AW
authors.lastname: Ho
authors.affiliation: Department of Orthopaedics and Traumatology, Caritas Medical Centre, Shamshuipo, Hong Kong.
authors.forename: S H
authors.initials: SH
authors.lastname: Wong
mesh_terms: D017677:Age Distribution; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006723:Hong Kong / Q000453:epidemiology; D006779:Hospitals, Public; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011184:Postoperative Period; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors
keywords: Aged, 80 and over; Hip fractures; Survival rate