Outcomes following fractured neck of femur in an Australian metropolitan teaching hospital

Bone and Joint Research - Tập 2 Số 8 - Trang 162-168 - 2013
Ping Han Chia1, L. Gualano1, Siven Seevanayagam2, Laurence Weinberg3
1Northern Hospital, Department of Anaesthesia, 185 Cooper Street, Epping, Victoria 3076, Australia.
2Changi General Hospital, Department of Anaesthesia, 2 Simei Street 3, 529889, Singapore.
3Austin Hospital, Department of Anaesthesia, PO Box 5555, Heidelberg, Victoria 3084, Australia.

Tóm tắt

Objectives To determine the morbidity and mortality outcomes of patients presenting with a fractured neck of femur in an Australian context. Peri-operative variables related to unfavourable outcomes were identified to allow planning of intervention strategies for improving peri-operative care. Methods We performed a retrospective observational study of 185 consecutive adult patients admitted to an Australian metropolitan teaching hospital with fractured neck of femur between 2009 and 2010. The main outcome measures were 30-day and one-year mortality rates, major complications and factors influencing mortality. Results The majority of patients were elderly, female and had multiple comorbidities. Multiple peri-operative medical complications were observed, including pre-operative hypoxia (17%), post-operative delirium (25%), anaemia requiring blood transfusion (28%), representation within 30 days of discharge (18%), congestive cardiac failure (14%), acute renal impairment (12%) and myocardial infarction (4%). Mortality rates were 8.1% at 30 days and 21.6% at one year. Factors predictive of one-year mortality were American Society of Anesthesiologists (ASA) score (odds ratio (OR) 4.2 (95% confidence interval (CI) 1.5 to 12.2)), general anaesthesia (OR 3.1 (95% CI 1.1 to 8.5)), age > 90 years (OR 4.5 (95% CI 1.5 to 13.1)) and post-operative oliguria (OR 3.6 (95% CI 1.1 to 11.7)). Conclusions Results from an Australian metropolitan teaching hospital confirm the persistently high morbidity and mortality in patients presenting with a fractured neck of femur. Efforts should be aimed at medically optimising patients pre-operatively and correction of pre-operative hypoxia. This study provides planning data for future interventional studies. Cite this article: Bone Joint Res 2013;2:162–8.

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Bone and Joint Research

Tập 2 Số 8

162-168

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