Abstract
Summary: Hip fractures are a serious public health issue with major consequences, especially for frail community dwellers. This study found a poor prognosis at 6 months post-trauma with regard to life expectancy and rehabilitation to pre-fracture independency levels. It should be realized that recovery to pre-trauma functioning is not a certainty for frail community-dwelling patients. Introduction: Proximal femoral fractures are a serious public health issue in the older patient. Although a significant rise in frail community-dwelling elderly is expected because of progressive aging, a clear overview of the outcomes in these patients sustaining a proximal femoral fracture is lacking. This study assessed the prognosis of frail community-dwelling patients who sustained a proximal femoral fracture. Methods: A multicenter retrospective cohort study was performed on frail community-dwelling patients with a proximal femoral fracture who aged over 70 years. Patients were considered frail if they were classified as American Society of Anesthesiologists score ≥ 4 and/or a BMI < 18.5 kg/m2 and/or Functional Ambulation Category ≤ 2 pre-trauma. The primary outcome was 6-month mortality. Secondary outcomes were adverse events, health care consumption, rate of institutionalization, and functional recovery. Results: A total of 140 out of 2045 patients matched the inclusion criteria with a median age of 85 (P25–P75 80–89) years. The 6-month mortality was 58 out of 140 patients (41%). A total of 102 (73%) patients experienced adverse events. At 6 months post-trauma, 29 out of 120 (24%) were readmitted to the hospital. Out of the 82 surviving patients after 6 months, 41 (50%) were unable the return to their home, and only 32 (39%) were able to achieve outdoor ambulation. Conclusion: Frail community-dwelling older patients with a proximal femoral fracture have a high risk of death, adverse events, and institutionalization and often do not reobtain their pre-trauma level of independence. Foremost, the results can be used for realistic expectation management.
Original language | English |
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Pages (from-to) | 1465-1475 |
Number of pages | 11 |
Journal | Osteoporosis International |
Volume | 33 |
Issue number | 7 |
Early online date | 9 Apr 2022 |
DOIs | |
Publication status | Published - Jul 2022 |
Bibliographical note
Funding Information:SAIL, MHJV, EMMVL, and PJ received financial support from the Netherlands Organization for Health Research and Development (ZonMw; ref.nr. 843004120) and Osteosynthesis and Trauma Care Foundation (ref.nr. 2019-PJKP) for the submitted work. The authors have no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.
Publisher Copyright:
© 2022, The Author(s).