Article

OBJECTIVES: To determine 1-year mortality and predisposing factors in older
people who had surgery after a hip fracture. DESIGN: Prospective cohort study.
SETTING: Public acute hospital, trauma service. PARTICIPANTS: Patients (N=281)
aged >/=65 years who were admitted to the hospital with a hip fracture from
January 2009 to January 2010, and followed up for 1 year thereafter.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Cumulative survival
probability up to 1 year from surgery was calculated by means of Kaplan-Meier
charts, and Cox regression models were performed to analyze the factors
associated with mortality. Data were collected from medical charts and by
interviews. Health status was evaluated using the American Society of
Anesthesiologists rating, prefracture functional level with the FIM, and
cognitive status with the Pfeiffer score. RESULTS: The 1-year mortality for the
281 patients who were followed up was 21% (95% confidence interval [CI],
16.1%-25.9%). A non-weight-bearing status was associated with increased mortality
in unadjusted analyses (hazard ratio [HR]=1.99; 95% CI, 1.16-3.43), but 5 other
factors were identified when entered into the multiple Cox regression model: age
(HR=1.05; 95% CI, 1-1.09), male sex (HR=2.92; 95% CI, 1.58-5.39), low health
status (HR=2.8; 95% CI, 1.29-6.09), low prefracture function (HR=.98; 95% CI,
.97-.99), and change of residence (HR=3.21; 95% CI, 1.43-7.17). CONCLUSIONS: The
overall 1-year mortality rate was 21%. Change of residence is the only
potentially modifiable risk factor, independent of the following other
traditional risk factors that were found: age, sex, health status, and
prefracture functional level. Furthermore, 2 to 4 weeks of non-weight-bearing
status, which is considered modifiable, is also associated with increased
mortality rates in unadjusted analyses.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS