Key result
In elderly patients with femoral intertrochanteric fractures, a history of stroke significantly increased one-year postoperative mortality (adjusted OR 4.303) compared to those without stroke.
Why the study?
Does a history of stroke increase one-year postoperative mortality and worsen ambulatory recovery in elderly patients with femoral intertrochanteric fractures?
Cohort (n=80)
No
Does a history of stroke increase one-year postoperative mortality and worsen ambulatory recovery in elderly patients with femoral intertrochanteric fractures?
Odds Ratio: 4.303 (95% CI 1.341–13.812)
Absolute Event Rate: 42.9% vs 17.7%
p-value: p=0.014
Stroke is a significant independent predictor of one-year mortality, but not ambulatory recovery, in elderly patients undergoing surgery for intertrochanteric fractures.
Stroke history may prompt enhanced postoperative surveillance in elderly intertrochanteric fracture patients; leaves open whether interventions mitigate excess mortality.
Purpose: The purpose of this study was to compare the general characteristics that affect the prognosis and evaluate the influence of stroke on one-year postoperative mortality and recovery of ambulatory status in elderly patients over 65 years old with femoral intertrochanteric fracture. Materials and Methods: This study included 80 patients who were followed-up for one year after proximal femoral nailing for femur intertrochanteric fracture between January 2008 and December 2013. We analyzed the relationship among the one-year postoperative mortality, recovery of ambulatory status and the associated factors (age, gender, associated underlying disease, American Society of Anesthesiologists [ASA] grade, comminution of the fracture, dementia). Results: The one-year postoperative mortality rate in all patients and patients with stroke was 28.8% and 42.9%, respectively. The oneyear postoperative mortality rate was significantly higher in patients with stroke, high ASA grade, and unstable fracture. Decrease of the one-year postoperative ambulatory status was 50.9% in all patients and was significantly associated with grade III or IV ASA rating. No significant relationships were observed between the one-year postoperative recovery of ambulatory status and stroke. Conclusion: Stroke, ASA grade, and unstable fracture were prognostic factors associated with one-year postoperative mortality following intertrochanteric fracture. ASA rating was the only prognostic factor affecting one-year postoperative recovery of ambulatory status.
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Hwang et al. (2016) conducted a cohort in Femoral intertrochanteric fracture (n=80). Stroke vs. No stroke was evaluated on One-year postoperative mortality (OR 4.303, 95% CI 1.341-13.812, p=0.014). In elderly patients with femoral intertrochanteric fractures, a history of stroke significantly increased one-year postoperative mortality (adjusted OR 4.303) compared to those without stroke.
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