Analysis of and countermeasures for inpatient deaths from orthopaedic and traumatic hip fractures

Abstract

Objective To analyze the inpatient deaths from orthopaedic and traumatic hip fractures and to provide countermeasures to reduce such deaths.Methods A retrospective study was performed to analyze the inpatient deaths from hip fractures in our department from January 1999 to January 2013.Their clinical features,causes of death,major complications,and risk factors leading to death were analyzed to find out preventative measures.Results The hospital mortality of hip fracture inpatients was 1.12％ (21/1,881).Of the 21 deaths,11 were male and 10 female.Their ages averaged 79.8 ± 6.7 years (from 62 to 93 years).They were hospitalized for trauma,caused by falling in 19 cases,traffic accident in one,and falling from a height in one.There were one acetabular fracture,7 femoral neck fractures,11 intertrochanteric fractures and 2 subtrochanteric fractures.Of the 21 deaths,the average hemoglobin level was 114.5 ± 18.6 g/L,the average total protein level 58.6 ± 10.9 g/L,and the average albumin level 33.2 ±8.5 g/L before operation.They all received surgery.Their major complications were respiratory disease in 14 cases (66.67％),cardiovascular disease in 16 cases (76.19％),cerebrovascular disease in 5 cases (23.81％),and urinary system disease in one (4.76％).The causes of death were respiratory failure in 11 cases (52.38％),pulmonary embolism in 4 cases (19.05％),multiple organ dysfunction syndrome in 3 cases (14.29％),acute myocardial infarction in one (4.76％),cerebral hemorrhage in one(4.76％) and cerebral infarction in one (4.76％).Conclusions The inpatient deaths from hip fractures may occur in the elderly who are complicated with several internal disorders,especially respiratory and cardiovascular diseases.Since respiratory failure caused by pulmonary infection is the chief cause for deaths in the old inpatients with hip fracture,it should be regarded with great caution in order to reduce the post-traumatic mortality. Key words: Acetabulum; Fractures, bone; Hip fractures; Mortality