Key result
A history of prior stroke was strongly associated with inpatient stroke (OR 13.24) among elderly patients with hip fractures, which in turn increased mortality risk (OR 7.17).
Observational (n=37,584)
Yes
Odds Ratio: 13.24
Inpatient stroke after hip fracture in the elderly is rare (0.4%) but catastrophic, with significantly increased mortality and serious adverse events, especially in those with prior stroke.
Prior stroke history supports perioperative risk stratification in elderly hip fracture patients; leaves open whether targeted prevention reduces mortality.
Although uncommon, stroke can be a catastrophic inpatient complication for patients with hip fractures. The current study determines the incidence of inpatient stroke after hip fractures in elderly patients, identifies risk factors associated with such strokes, and determines the association of stroke with short-term inpatient outcomes. A retrospective review of all patients aged 65 years or older with isolated hip fractures in the 2011 and 2012 National Trauma Data Bank was conducted. A total of 37,584 patients met inclusion criteria. Of these patients, 162 (0.4%) experienced a stroke during their hospitalization for the hip fracture. In multivariate analysis, a history of prior stroke (odds ratio [OR], 13.24), coronary artery disease (OR, 2.05), systolic blood pressure 180 mm Hg or higher (OR, 1.66), and bleeding disorders (OR, 1.65) were associated with inpatient stroke. Inpatient stroke was associated with increased mortality (OR, 7.17) and inpatient serious adverse events (OR, 6.52). These findings highlight the need for vigilant care of high-risk patients, such as those with a history of prior stoke, and for an understanding that patients who experience an inpatient stroke after a hip fracture are at significantly increased risk of mortality and inpatient serious adverse events. [Orthopedics. 2018; 41(1):e27-e32.].
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Samuel et al. (2017) conducted an observational in isolated hip fractures (n=37,584). History of prior stroke was evaluated on inpatient stroke (OR 13.24). A history of prior stroke was strongly associated with inpatient stroke (OR 13.24) among elderly patients with hip fractures, which in turn increased mortality risk (OR 7.17).
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