ORIGINAL ARTICLES
Venous thromboembolism and mortality after hip fracture surgery: the ESCORTE study1, 2

https://doi.org/10.1111/j.1538-7836.2005.01545.xGet rights and content
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Summary

Background: Recent changes in the management of hip fracture surgery patients may have modified the epidemiology of postoperative complications. Objectives: We performed an observational study of a cohort of patients undergoing hip fracture surgery to update the epidemiological data on this population. The primary study outcome was the incidence of confirmed symptomatic venous thromboembolism (VTE) [defined as deep vein thrombosis, pulmonary embolism (PE), or both] at 3 months. Overall mortality at 1, 3 and 6 months was also evaluated. Patients/methods: Consecutive patients aged at least 18 years hospitalized in French public or private hospitals (531 centers) undergoing hip fracture surgery were recruited prospectively during 2 months in 2002 and a follow‐up at 6 months. Predictive factors for VTE at 3 months and for death at 6 months were also analyzed. Results: Data from 6860 (97.3%) of the 7019 recruited patients were included in the analysis. The median age was 82 years. Low molecular weight heparins were administered perioperatively in 97.6% of patients; 69.5% received this treatment for at least 4 weeks. The actuarial rate of confirmed symptomatic VTE at 3 months was 1.34% (85 events, 95% CI: 1.04–1.64). There were 16 PEs (actuarial rate: 0.25%), three of which were fatal. Overall, 1006 (14.7%) patients were dead at 6 months. Cardiovascular disease was the most frequent cause of death (270 patients; 26.8%). Conclusions: The current rate of postoperative VTE is low, but overall mortality remains high. Indeed, hip fracture patients belong to a vulnerable group of old people with comorbid diseases and a high risk of postoperative morbidity and mortality. An interdisciplinary approach could be the challenge to improve short and long‐term outcome.

Keywords

epidemiology
hip fracture surgery
mortality
venous thromboembolism

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1

This work was presented as an abstract at the Congress of the European Society of Anaesthesiologists, Euroanaesthesia, Lisbon, Portugal, June 5–8, 2004 [European Journal of Anaesthesia 2004; 21 (Supp. 32): 82].

2

Committees and Investigators participating in the study are listed in the Appendix.