Background: There are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients.
Methods: The study included all patients with a hip fracture older than 65 who had been admitted to the Clinic for orthopaedic surgery during one year. One hundred and ninety-two patients were included in the study.
Results: Six months after admission due to a hip fracture, 48 patients had died (6-month mortality rate was 25%). The deceased were statistically older than the patients who had survived. Univariate regression analysis indicated that six variables had a significant effect on hip fracture patients' survival: age, mobility prior to the fracture, poor cognitive status, activity of daily living, comorbidities and the place where they had fallen. Multivariate regression modelling showed that the following factors were independently associated with mortality at 6 months post fracture: poor cognitive status, poor mobility prior to the fracture, comorbid disease.
Conclusion: Poor cognitive status appeared to be the strongest mortality predictor. The employment of brief tests for cognitive status evaluation would enable orthopaedists to have good criteria for the choice of treatment for each patient screened.
Izhodišča: Obstaja več možnih dejavnikov tveganja za višjo stopnjo umrljivosti, kot so spremljajoče bolezni, slabo splošno zdravstveno stanje, starost, moški spol, zmanjšana mobilnost pred poškodbo, tip zloma, slab kognitivni status, kraj bivanja. Cilj te študije je bil oceniti vpliv možnih dejavnikov tveganja na šestmesečno smrtnost pri bolnikih z zlomom kolka.
Metode: Študija je vključevala vse bolnike z zlomom kolka, starejše od 65 let, ki so bili sprejeti na Kliniko za ortopedsko kirurgijo in travmatologijo v enem letu. V raziskavo je bilo vključenih 192 bolnikov.
Rezultati: Šest mesecev po sprejemu zaradi zloma kolka je umrlo 48 bolnikov (šestmesečna smrtnost je bila 25%). Umrli so bili statistično starejši od bolnikov, ki so preživeli (p<0,001). Univariantna regresijska analiza je pokazala, da je šest spremenljivk pomembno vplivalo na preživetje bolnikov z zlomom kolka: starost, mobilnost pred zlomom, slab kognitivni status, vsakodnevne aktivnosti, komorbidnost in kraj, kjer so padli. Multivariantno regresijsko modeliranje je pokazalo, da so naslednji dejavniki bili neodvisno povezani z umrljivostjo šest mesecev po zlomu: slab kognitivni status, slaba mobilnost pred zlomom in komorbidne bolezni.
Zaključek: Zdi se, da je slabo kognitivno stanje najmočnejši napovedni dejavnik umrljivosti pri bolnikih z zlomom kolka. Uporaba kratkih testov za oceno kognitivnega stanja bi ortopedom omogočila dober kriterij za izbiro načina zdravljenja pri obravnavanem bolniku.
Keywords: cognitive status; comorbidity; hip fracture; kognitivni status; komorbidnost; poor cognitive status; six-month mortality; slabo kognitivno stanje; zlom kolka; šestmesečna umrljivost.