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Year to year comparison of 2000–2015 in hip fracture management: same survival rate despite older and more fragile patients

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Abstract

Purpose

The aim of this study was to compare clinical data, comorbidities and survival rates at 30 days and 1 year in two groups with femoral fractures, the first including patients admitted in 2000, and the other including patients admitted in 2015. The hypothesis of the study is that patients admitted in 2015 have more comorbidities and will therefore have a lower survival rate at 30 days and 1 year from trauma.

Methods

Patients admitted to the hospital with proximal femoral fractures in 2000 (90 patients) and 2015 (167 patients) were retrospectively reviewed. The following data were collected: age, gender, source of admission, ASA score, comorbidities, time from admission to surgery and length of hospital stay. The Charlson Comorbidity Index (CCI) score, a measure of comorbidity, and the Nottingham Hip Fracture Score (NHFS), a predictor of 30-day and 1-year mortality after hip fracture, were both calculated.

Results

Patients in the 2015 group were older and more institutionalized before fracture (p < 0.05), with a significant increase in Alzheimer’s disease, chronic obstructive pulmonary disease, congestive heart failure and renal impairment. The length of stay was significantly lower in 2015. The NHFS and CCI were significantly higher in 2000. Mortality at 30 days and 1 year did not differ significantly in 2000 when compared to 2015. The CCI had the best predictive ability for mortality in both groups at 30 days and 1 year.

Conclusions

The increase of comorbidities was not found to be correlated to increased mortality. This could be explained by enhanced patient management permitting earlier mobilization and weight bearing.

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Authors and Affiliations

  1. Università degli Studi di Milano Bicocca, Via Grigna 11, 20900, Monza, Italy

    Carlo Trevisan & Gianluca Gallinari

  2. ASST Bergamo Est, Ospedale Bolognini, Via Paderno 21, 24068, Seriate, Italy

    Carlo Trevisan & Raymond Klumpp

  3. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy

    Alessandra Menon & Riccardo Compagnoni

  4. 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy

    Alessandra Menon & Riccardo Compagnoni

Authors
  1. Carlo Trevisan
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  2. Gianluca Gallinari
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  3. Raymond Klumpp
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  4. Alessandra Menon
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  5. Riccardo Compagnoni
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Corresponding author

Correspondence to Riccardo Compagnoni.

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Conflict of interest

The authors declare no conflict of interest in this work.

Statement of human and animal rights

This study was performed respecting human rights as recommended by the declaration of Helsinki.

Informed consent

The study was conducted on medical records and ethic committee approved the study without the request of informed consent.

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Trevisan, C., Gallinari, G., Klumpp, R. et al. Year to year comparison of 2000–2015 in hip fracture management: same survival rate despite older and more fragile patients. Aging Clin Exp Res 31, 1097–1103 (2019). https://doi.org/10.1007/s40520-018-1047-1

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  • DOI: https://doi.org/10.1007/s40520-018-1047-1

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