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Archives of Orthopaedic and Trauma Surgery

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01.10.2011 | Osteoporotic Fracture Management

Long-term functional outcome in geriatric hip fracture patients

verfasst von: Christian Kammerlander, Markus Gosch, Ursula Kammerlander-Knauer, Thomas J. Luger, Michael Blauth, Tobias Roth

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2011

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Abstract

Background

Fragility fractures are a major health care problem worldwide. The proportion of the geriatric population and the overall life expectancy will increase. Hip fractures are the most common fragility fractures needing surgery and nowadays treatment concepts are changing. We studied the long-term functional outcome and their influencing factors in patients treated without any interdisciplinary aspects.

Design and setting

A retrospective cohort study with functional long-term follow-up examination was carried out in a level one trauma centre on hip fracture patients 80 years old and above treated without any formalized interdisciplinary aspects (“usual care”).

Patients

Of 281 consecutive patients who were treated 2005 and 2006 with usual care, 246 patients with a mean age of 86.8 years met our inclusion criteria. 69.1% died within the study period of 4.9 years. On the remaining patients, the residential status, the Barthel Index and the Parker Score were assessed.

Results

The mean Barthel Index was 49.6 and the mean Parker Score was 2.7. More than one-fourth of the survivors were found to be bedridden and 45% were not able to walk outside. 88% are bound to one floor and only 8% are able to walk unaided. Patients with more comorbidities and patients with subsequent fractures had significant higher mortality rates. Patients with trochanteric fractures had significant better functional outcome scores compared to patients with femoral neck fractures. Nursing home residents showed significant higher mortality rates and lower functional outcome scores. Patients who were transferred to a nearby acute geriatric hospital for further treatment had significantly higher functional outcome scores.

Conclusion

This paper shows the frustrating long-term outcome of geriatric hip fracture patients but it also suggests that an early geriatric intervention may lead to better function.

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Titel: Long-term functional outcome in geriatric hip fracture patients
verfasst von: Christian Kammerlander
Markus Gosch
Ursula Kammerlander-Knauer
Thomas J. Luger
Michael Blauth
Tobias Roth
Publikationsdatum: 01.10.2011
Verlag: Springer-Verlag
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2011
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1313-6

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Long-term functional outcome in geriatric hip fracture patients