Hip # Outcome Predictors - Pete Thompson 16/8/2000
Outcome post hip fracture is a difficult 'measurement' and predicting outcome even more difficult due to the complex interaction of a huge number of factors including pt. mix, co-morbidities, treatment, timing of treatment pre- and postoperative care. This is reflected in the fairly wide range of mortality reported.
Age and cognitive ability are the two most important predictive factors of survival followed by co-morbidities (1,2) but these factors are not entirely independent of each other. Operative delay in medically unfit pts is actually associated with increased survival but delay in fit patients should be avoided (1). Postoperatively poor mobility and post-op complications correlate with higher mortality rates.
Having some idea of likely outcome is helpful in identifying 'at-risk' groups. The Functional Recovery Score (3,4) may become a commonly used outcome score for assessment of such pts and to help compare grps of pts in future studies.
1
|
Authors
|
S.B. Sexton and J.T. Lehner
|
|
Title
|
Factors Affecting Hip Fracture Mortality
|
|
Reference
|
Journal of Orthopaedic Trauma Vol. 1, No. 4 (1988) 298-305
|
|
Summary
|
Increased mortality is associated with age, mental state, mobility on discharge, pre-op. co-morbidities and development of post-op complications. Operative delay in healthy individuals increases mortality but has no significant effect in medically fit patients.
|
|
Critique
|
Retrospective review of heterogeneous group of 300 hip # pts.
|
2
|
Authors
|
G.K. Ions and J. Stevens
|
|
Title
|
Prediction Of Survival In Patients With Femoral Neck Fractures.
|
|
Reference
|
J.B.J.S. 69-B (3) (1987) 384-387
|
|
Summary
|
Mental test score, age, CVA and malignancy correlated best with mortality. Injury outside of the home and ability to carryout own shopping correlate with increased survival. Chest infection is commonest cause of death.
|
|
Critique
|
Prospective study with strict protocol and only one operating surgeon. Reasonable nos. and sensible conclusions.
|
Please log in to view the content of this page.
If you are having problems logging in, please refer to the login help page.
|
