No rest for elderly femur fracture patients: early surgery and early ambulation decrease mortality
- PDF / 845,014 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 86 Downloads / 204 Views
ORIGINAL ARTICLE
Journal of Orthopaedics and Traumatology Open Access
No rest for elderly femur fracture patients: early surgery and early ambulation decrease mortality Alessandro Aprato* , Marco Bechis, Marco Buzzone, Alessandro Bistolfi, Walter Daghino and Alessandro Massè
Abstract Background: Literature has shown a significant correlation between early treatment and mortality in femur fractures, but the influence of time to ambulation on mortality has not been studied. The purpose of the present study is to evaluate whether time to ambulation is correlated to femur fracture mortality independently from time to surgery. Patients and methods: All patients older than 65 years admitted at a level I trauma center with proximal femoral fracture during a 1-year period were included. The following data were collected: age, gender, date and time of admission to emergency department, height, weight, body mass index, type and side of fracture, ASA score, date and time of surgery, surgical time, time to ambulation, length of hospitalization, death during hospitalization, and mortality at 6 and 12 months. Results: The study sample comprises 516 patients. The mean age was 83.6 years; ASA score was 3–5 in 53% of patients; 42.7% presented with medial fracture; mean time between admission and surgery was 48.4 h; 22.7% of patients were not able to walk during the first 10 days after fracture; mean duration of hospitalization was 13 days; and mortality was 17% at 6 months and 25% at 1 year. Early surgery and walking ability at 10 days after trauma were independently and significantly associated with mortality at 6 months (p = 0.014 and 0.002, respectively) and at 1 year (0.027 and 0.009, respectively). Conclusions: Early surgery in femur fracture became a priority in health systems, but early postoperative physiotherapy also plays a major role in prevention of mortality: independently from surgical timing, patients who did not walk again within 10 days from surgery showed mortality rates higher than those of patients who did. Level of evidence: IV. Keywords: Femur fracture, Early treatment, Walking Highlights 1. Patients who do not walk again within 10 days from surgery have mortality rates almost double than those of patients who do (6% versus 11% at 6 months and 7% versus 17% at 1 year).
*Correspondence: [email protected] School of Medicine, University of Turin, Viale 25 Aprile 137 Int 6, 10133 Turin, Italy
2. Walking ability at 10 days after trauma is significantly associated with mortality at 6 months and at 1 year independently from early surgery (within 48 h).
Introduction Hip fractures in the elderly represent a major public health burden worldwide [1], and aging of population is increasing its rate [2, 3]. Mortality is reported to be up to 25% at 1 year [4], and several changeable factors may contribute to this event [5]. Literature has shown a significant correlation between early treatment and mortality,
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 Internation
Data Loading...
