Outcomes following fractured neck of femur in an Australian metropolitan teaching hospital. Issue 8 (August 2013)

• Record Type: Journal Article
• Authors: Chia, P. H.; Gualano, L.; Seevanayagam, S.; Weinberg, L.
• Is Part Of: Bone & joint research. Volume 2:Issue 8(2013)
• Page Start: 162
• Page End: 168
• Publication Date: 2013-08
• Subjects: Hip fracture -- Neck of femur -- Anaesthesia -- Complications -- Morbidity -- Mortality; Musculoskeletal system -- Periodicals; 573.705
• DOI: 10.1302/2046-3758.28.2000177
• Languages: English
• ISSNs: 2046-3758

Abstract

Abstract : Objectives: To determine the morbidity and mortality outcomes of patients presenting with a fractured neck of femur in an Australian context. Peri-operative variables related to unfavourable outcomes were identified to allow planning of intervention strategies for improving peri-operative care. Methods: We performed a retrospective observational study of 185 consecutive adult patients admitted to an Australian metropolitan teaching hospital with fractured neck of femur between 2009 and 2010. The main outcome measures were 30-day and one-year mortality rates, major complications and factors influencing mortality. Results: The majority of patients were elderly, female and had multiple comorbidities. Multiple peri-operative medical complications were observed, including pre-operative hypoxia (17%), post-operative delirium (25%), anaemia requiring blood transfusion (28%), representation within 30 days of discharge (18%), congestive cardiac failure (14%), acute renal impairment (12%) and myocardial infarction (4%). Mortality rates were 8.1% at 30 days and 21.6% at one year. Factors predictive of one-year mortality were American Society of Anesthesiologists (ASA) score (odds ratio (OR) 4.2 (95% confidence interval (CI) 1.5 to 12.2)), general anaesthesia (OR 3.1 (95% CI 1.1 to 8.5)), age > 90 years (OR 4.5 (95% CI 1.5 to 13.1)) and post-operative oliguria (OR 3.6 (95% CI 1.1 to 11.7)). Conclusions: Results from an Australian metropolitan teaching hospital confirm the persistently high morbidity and mortality in patients presenting with a fractured neck of femur. Efforts should be aimed at medically optimising patients pre-operatively and correction of pre-operative hypoxia. This study provides planning data for future interventional studies. Cite this article: Bone Joint Res 2013;2:162–8.