Key result
In elderly patients undergoing cephalomedullary nail osteosynthesis for hip fracture, 45% experienced worsened autonomy and the mortality rate was 24.6% at 27 months.
Why the study?
What are the autonomy and mortality outcomes in elderly patients submitted to proximal femoral osteosynthesis with cephalomedullary nail after hip fracture?
Cohort (n=61)
What are the autonomy and mortality outcomes in elderly patients submitted to proximal femoral osteosynthesis with cephalomedullary nail after hip fracture?
Hip fracture and subsequent cephalomedullary nail osteosynthesis in elderly patients is associated with a 24.6% mortality rate and decreased independence, with outcomes influenced by preoperative autonomy, age, and surgical timing.
Worsened autonomy in 45% and 24.6% mortality caution expectations after cephalomedullary nailing; leaves open prospective validation of risk factors.
OBJECTIVE: To determine the autonomy and mortality of elderly patients submitted to proximal femoral osteosynthesis with cephalomedullary nail after hip fracture. METHODS: Retrospective study with 61 patients with proximal femoral fractures submitted to cephalomedullary nail osteosynthesis. The authors analyzed the medical records and collected information from the preoperative period. Patients were questioned regarding pain, postoperative autonomy, and degree of satisfaction. The total number of deaths was verified. The results were then correlated. RESULTS: The mean age was 84 years, predominantly female (82%). In the postoperative evaluation, 45% of the patients presented worsened levels of autonomy. The majority of patients presented mild pain (61%) on the VAS scale. The mortality rate was 24.6%, and the mean time of preoperative hospitalization was three days. The factors that presented statistical significance regarding postoperative autonomy were the time elapsed from the trauma until the moment of surgery, ASA score, fracture stability, and previous functional status of the patients. The mortality rate was associated with three main factors: advanced age, ASA score, and preoperative hospitalization time. CONCLUSION: The patient's previous autonomy positively influenced the functional outcome and postoperative recovery. Unstable fractures presented worse results for pain and ambulation in a follow-up of 27 months. Hip fracture is a risk factor associated with mortality and decreased independence in patients over 65 years of age.
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Petros et al. (2017) conducted a cohort in Proximal femoral fractures (n=61). Proximal femoral osteosynthesis with cephalomedullary nail was evaluated on Mortality. In elderly patients undergoing cephalomedullary nail osteosynthesis for hip fracture, 45% experienced worsened autonomy and the mortality rate was 24.6% at 27 months.
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