Abstract
BackgroundHip fractures are associated with increased cerebrovascular accidents (CVAs) in the first postoperative year. Long-term follow-up for CVA and mortality after hip fracture is lacking. The purpose of this study was to identify risk factors for CVA and follow mortality in hip fractures in a cohort with greater than 2 years follow-up.MethodsWe compared past medical history of patients with hip fractures to long-term survival and the occurrence of CVA. Past medical history, surgical intervention, CVA occurrence, and death were queried from the electronic medical recorder system. Level of significance was set at p < 0.05 with 95% confidence interval.ResultsTwo thousand one hundred ninety-five patients met inclusion criteria. Mean follow-up was 5 years. One hundred ten (5.01%) patients were diagnosed with post-fracture CVA. Forty-one patients had CVA in the first year and 55 patients had CVA between 1 to 5 years after surgery. Among the potential risk factors, hypertension (HTN), atrial fibrillation (AF), and diabetes mellitus (DM) had the highest odds ratio for CVA (OR = 1.885, p value = 0.005; OR = 1.79, p value = 0.012; OR = 1.66, p value = 0.012). The median survival time in patients with CVA was 51.12 ± 3.76 months compared to 59.60 ± 0.93 months in patients without CVA (p = 0.033).ConclusionsHTN, AF, and DM are significant risk factors for the occurrence of CVA after hip fracture. The majority of CVAs occur between the first and fifth year postoperatively, and CVA is a negative prognostic factor for postoperative survival.
Highlights
Hip fractures are associated with increased cerebrovascular accidents (CVAs) in the first postoperative year
Of the 2195 hip fracture cases included in the study, 385 patients (17.5%) were diagnosed with CVA
Forty-one patients had CVAs in the first year post fracture whereas 55 patients had CVAs in years 1 through 5
Summary
Hip fractures are associated with increased cerebrovascular accidents (CVAs) in the first postoperative year. Long-term follow-up for CVA and mortality after hip fracture is lacking. The purpose of this study was to identify risk factors for CVA and follow mortality in hip fractures in a cohort with greater than 2 years follow-up. The importance of identifying risk factors for CVA after hip fracture cannot be understated, as the negative implications to a patient’s health, the increased risk of post-fracture death, and the economic and societal burdens are cumbersome. Information about the association of hip fractures and CVA is limited. Studies exploring risk factors for CVA after hip fractures are generally limited by a short follow-up period of 1 year after the initial insult.
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