Factors affecting postoperative mortality of patients with displaced femoral neck fracture

• Published in: Injury Vol. 37; no. 8; pp. 705 - 711
• Main Authors: Petersen, M.B., Jørgensen, H.L., Hansen, K., Duus, B.R.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.08.2006; Elsevier
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Biological and medical sciences; Complications; Denmark; Diseases of the osteoarticular system; Displaced femoral neck fracture; Female; Femoral Neck Fractures - mortality; Femoral Neck Fractures - surgery; Follow-Up Studies; Garden type 3–4; Hemiarthroplasty; Humans; Injuries of the limb. Injuries of the spine; Length of Stay; Male; Medical sciences; Mortality; Neurology; Retrospective Studies; Risk Factors; Sex Factors; Survival Rate; Traumas. Diseases due to physical agents; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Denmark; Displaced femoral neck fracture; Hemiarthroplasty; Garden type 3–4; Complications; Mortality; Heart; Femoral neck; Fracture dislocation; Prognosis; Prosthesis; Diseases of the osteoarticular system; Cardiovascular disease; Male; Multivariate analysis; Epidemiology; Waiting time; Garden type 3-4; Vascular disease; Regulation(control); Complication; Female; Hospital; Woman; Cerebrovascular disease; Age; Human; Postoperative; Garden; Nervous system diseases; Stroke; Survival; Cerebral disorder; Orthopedic surgery; Treatment; Central nervous system disease; Danish; Models; Bone; Predictive factor; Dementia
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2006.02.046

Displaced femoral neck fractures are known to be associated with high rates of mortality. The purpose of the present study is to investigate pre- and postoperative factors which influence this mortality in a series of 1186 consecutive Danish patients presenting to one hospital's orthopaedic department with Garden type 3–4 fractures. Subsequent mortality data was obtained from the state population register (224 were still alive). The stepwise Cox proportional hazards model was used for multivariate analysis in order to obtain the predictors of postoperative mortality. The median survival of male subjects fell from 5.2 years in an age-matched control population to 1.6 years in the patients. In women survival time fell from 6.6 to 2.8 years. Almost all excess mortality occurred during the first 3 months following hemiarthroplasty. In order of significance, key factors negatively influencing mortality at 3 months were: cardiac complications, dementia, male sex, age, waiting time before operation, stroke and dislocation of the prosthesis and perioperative fracture. Of these, waiting time for surgery and dislocation of the prosthesis could be modified. A number of other studies have confirmed the importance of optimising these factors.