Key result
Hip fracture treatment in patients aged 70 and older between 1998-2003 showed no significant improvement in mortality (23% vs 24%) or good functional outcome (73% vs 82%) compared to 1978-1983.
Why the study?
Does hip fracture surgery in recent years improve mortality and quality of life compared to 20 years ago in elderly patients?
Cohort (n=1,486)
No
Does hip fracture surgery in recent years improve mortality and quality of life compared to 20 years ago in elderly patients?
Absolute Event Rate: 23% vs 24%
p-value: p=NS
Despite an increase in the number of hip fractures treated, there has been no significant improvement in mortality or quality of life over a 20-year period, though age remains not a contraindication for surgery.
No outcome gains over 20 years in elderly hip fracture care warrant caution against assuming progress; leaves open targeted research into modifiable factors.
As the world population ages, the prevalence of osteoporosis and the incidence of hip fractures will increase dramatically, being responsible for an increase of the health expenditure. On the other hand, there is the inescapable fact of scarcity creating the necessity of making difficult choices with regard to the allocation of human resources. So the question remains: should we carry on investing an important part of our health expenditure for the treatment of hip fractures in elderly people? To answer this statement, we compared 384 hip fracture patients of 70 years and older treated in our department between 1978 and 1983 with 1102 patients treated between 1998 and 2003. Both groups had a prospective follow-up of at least one year. There were no statistically significant differences: mortality rate 24% vs. 23%; good functional outcome 82% vs. 73%; and home going rate 60% vs. 66%. The factors influencing these results were studied. So we can conclude: The number of hip fractures treated nowadays has increased compared with twenty years ago; There is no significant improvement in mortality, nor in quality of life; Age is not a contraindication for hip fracture surgery.
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Fierens et al. (2006) conducted a cohort in Hip fracture (n=1,486). Hip fracture treatment between 1998 and 2003 vs. Hip fracture treatment between 1978 and 1983 was evaluated on Mortality rate (p=NS). Hip fracture treatment in patients aged 70 and older between 1998-2003 showed no significant improvement in mortality (23% vs 24%) or good functional outcome (73% vs 82%) compared to 1978-1983.
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