Prediction of post-operative morbidity and mortality in hip fracture elderly patients

Abstract

Hip fracture is a devastating injury affecting a vast majority of the elderly individuals. The geriatric hip fracture occurs in a patient population subjected to the bone weakening by osteoporosis. The incidence of such fracture increases with age after the sixth decade.

A large number of studies have concluded that hip fracture is associated with high incidence of postoperative mortality and morbidity rates. The high mortality, particularly in the first three months, is probably due to the combination of trauma, major surgery in elderly people with concurrent medical problems, and a low physiological reserve.

Our study aimed to determine the capability of the Physiological and operative severity score for enumeration of mortality and morbidity score (POSSUM) to predict mortality and morbidity following hip fracture surgery .To determine the role of geriatric tools in predicting mortality and to determine mortality rates after hip fracture.

We recruited 100 elderly patients admitted to inpatients orthopedic wards for surgical correction of hip fracture. All patients were subjected to cognitive assessment (pre and postoperative), screening for depression, assessment of prefracture functional status by ADL and IADL, pain assessment by numerical pain scale and postoperative delirium. POSSUM scale was fulfilled. Patients were followed up by telephone calls at 30 days, 3 months and 6 months interval to determine observed and predicted morbidity and mortality and postoperative rehabilitation and ambulance.