HIP FRACTURES IN THE ELDERLY PATIENT
Background. Hip fractures are typical of the ageing
population. They represent a severe trauma for the elderly
patient due to significant impact on life quality and morbidity.
We analyzed the characteristics of patients with hip fractures,
the methods and success of treatment. In conclusion, the
importance of continuous team approach and surgical treatment
within 24 hours are stressed.
Methods. We retrospectively evaluated patients admitted for
femoral neck and intertrochanteric fractures between 1994–
1999. The incidence of these fractures, patient age and sex, comorbidity,
methods of treatment, hospital stay and success of
treatment with regard to ambulatory status were established.
Results. 662 patients were treated in the above mentioned period,
yielding a 1‰ annual incidence for the choosen population.
The mean patient age was 76 years; there were 426 female
(64%) and 236 male patients (36%). 336 patients (51%)
had a history of accompanying disease, in 73 patients (11%)
additional fractures were diagnosed. 30 patients (4.5%) were
treated conservatively, 632 (95.5%) underwent surgery. The
mean hospital stay length was 17 days. Success of treatment
was evaluated as good in 441 patients (67%), satisfactory in
112 patients (17%) and poor in 78 patients (12%). 31 patients
(5%) died during hospital admission.
Conclusions. Patients with hip fractures represent 10% of all
in-hospital trauma patients; with hospital stays twice as long
as average trauma patients and considering the financial demands
of surgical treatment they are a challenge in trauma
wards organization and management in the Slovenian environment.
Here as well as abroad the number of these patients
is increasing, along with their mean age and co-morbidity. It
is evident that hip fractures, regardless the way of treatment,
implicate a partial or complete loss of ambulancy and hence
loss of life-quality in one-third of patients. We advise early as
possible surgery –within 24 h– where not absolutely contraindicated
because of its significant influence on decreasing morbidity.
Good team-work between trauma-surgeons and anesthesiologists
is essential. Let us bear in mind that a hip fracture
in an elderly patient with coexisting disease is as lifethreatening
as multiple trauma in the young, otherwise healthy
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