Study of mid and long term outcome of hip fracture in elderly operated within 48 hours versus conservative management

Authors

  • Delis S. Marshall Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia http://orcid.org/0000-0002-2491-8137
  • Alan S. W. Ch’ng Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia Department of Medicine, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia http://orcid.org/0000-0002-3081-4182
  • Irene Looi Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia Department of Medicine, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia http://orcid.org/0000-0001-6217-5410

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20214172

Keywords:

Elderly fracture, Fracture neck of femur, Hip arthroplasty, Sub trochanteric fracture, Hip fracture

Abstract

Background: Hip fractures are commonly associated with high morbidities and mortalities. This study aimed to determine post-hip fracture outcomes and survival among patients who underwent operation within 48 hours of fracture diagnosis and among those being treated conservatively.

Methods: This retrospective cohort study was conducted at the Hospital Seberang Jaya among patients diagnosed with hip fracture from January to December 2016; confirmed clinical and radiological method. Descriptive analysis was conducted using Statistical package for social sciences (SPSS) version 23.

Results: The mean (SD) age of the 61 operated patients was 74 (7.7) years and for the 19 conservatively managed patients 79 (8.0) years. At 12 months, 30 (37.5%) of operated ones, required assisted mobility compared to 8 (10%) of conservatively managed patients. Other outcomes comparable between operated and conservative patients at 12 months post-intervention include: ability to feed on own 46 (57.5%) versus 7 (8.8%), able to dress on own, 45 (56.3%) versus 6 (7.5%); able to bathe on own; 43 (53.8%) versus 2 (2.5%), and independently attending to own toilet needs 44 (55.0%) versus 1 (1.3%). Our study revealed, overall survival were comparatively better among those operated to conservative at 12 months; 52 (85%) versus 9 (47.4%). The mortality at 12 months in the conservative group is much higher than operative group.

Conclusions: Ambulatory mobility and survival are significantly better at 12 months post-fracture among the operated patients. Hip fracture must be treated as an emergency and its surgical management given priority.

 

Author Biographies

Delis S. Marshall, Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia

medical officer , clinical research centre

Alan S. W. Ch’ng, Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia Department of Medicine, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia

GERIATICIAN, CLINICAL RESEARCH CENTRE

Irene Looi, Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia Department of Medicine, Hospital Seberang Jaya, Ministry of Health, Penang, Malaysia

NEUROLOGIST, CLINICAL RESEARCH CENTRE

References

H.A Karim. Global Theme issue: The elderly in Malaysia: Demographic trends Med J Malaysia. 1997;52(3):206-12.

Country Repost Malaysia. Available at: www.mblw.jp/bunya/kokusaigyomu/asean/2013/dl/Malaysia. Accessed on 8 March 2021.

Planning and Organization of Geriatric Services (World Health Organization; Technical Report Series No. 548). Available at: https://apps.who.int/iris/ bitstream/handle/10665/38754/WHO_TRS_548_eng.pdf?sequence=1. Assessed 24 February 2021.

Department of Statistics Malaysia; Population Distribution and Basic Demographic Characteristic Report 2010; Available at: https://www.dosm.go v.my/v1/index.php?r=column/ctheme&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09&bul_id=MDMxdHZjWTk1SjFzTzNkRXYzcVZjdz09#. Accessed on 15 January 2021.

My Health MOH. Malaysia. Osteoporosis. Available at: http://www.myhealth.gov.my/en/osteoporosis-2/. Accessed on 18 January 2021.

CPG osteoporosis 2012 (2nd edition 2015). Available at: file:///C:/Users/crchsj03/Downloads /CPG%20Management%20of%20Osteoporosis%20Second%20Edition%20(2015).pdf. Accessed on 25 January 2021.

Caeiro JR, Bartra A, Ramos MM, Etxebarria I, Monteio J, Carpintero P et al. Burden of First Osteoporotic Hip Fracture in Spain: A Prospective, 12-month, Observational Study. Calcif Tissue Int. 2017;100(1):29-39.

Eileen Tay; Singapore Med J. 2016 Apr; 57(4): 178-81.doi :10.11622/smedj.2016071.

Tan STS, Tan WPM, Jaipaul J, Chan SP, Sathappan SS. Clinical outcomes and hospital length of stay in 2,756 elderly patients with hip fractures: a comparison of surgical and non surgical management. Singapore Med J. 2017;58(5):253-7.

Lee JK, Khir ASM. The incidence of hip fracture in Malaysians above 50 years of age: variation in different ethnic groups. APLAR J Rheumatol. 2007;10:300-5.

NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA. 2001;285(6):785-95.

Hospital Seberang Jaya website; Available at: jknpenang.moh.gov.my/hsj/index.php/cluster. Accessed on 25 January 2021.

CRC website. Available at: www.crc.gov.my. Accessed on 25 January 2021.

Brauer CA, Perraillon MA, Cutler DM, Rosen ABD. Incidence and Mortality of Hip Fractures in the United States. JAMA. 2009;302(14):1573-9.

Cummings SR, Nevitt MC, Brower WS. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995;32:767-73.

Lloyd T, Johnson-Rollings N, Eggli DF, Kieselhorst K, Mauger EA, Cusatis D. Bone status among postmenopausal women with habitual caffeine intakes: a longituidinal investigation. J Am Coll Nutr. 2000;19:256-61.

Hannan MT, Felson DT, Dawson-Hughes B. Risk factors for longitudinal bone loss in elderly men and women: The Framingham Osteoporosis Study. J Bone Miner Res. 2000;15:710-20.

Klibanski A, Adams-Campbell L, Bassford T. Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA. 2001;285(6):785-95.

Yeap SS, Hew FL, Damodaran P, Chee W, Lee JK, Goh EML et al. A summary of the Malaysian Clinical Guidance on the management of postmenopausal and male osteoporosis. Osteoporosis and sarcopenia. 2016;52(3):201-3.

Azagra R, Lopez-Exposito F, Martin-Sanchez JC. Incidence of hip fracture in Spain (1997-2010). Med Clin. 2015;145:465-70.

Svedbom A, Borgstöm F, Hernlund E, Ström O, Alekna V, Bianchi ML et al. Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures—results from the ICUROS. Osteoporosis Int. 2017;12(4):42-9.

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Published

2021-10-26

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Original Research Articles