Abstract

OBJECTIVES:Hip fractures are a worldwide public health problem. The incidence of hip fracture is high among the elderly, and it is an important cause of death and disability in this population. This observational study aimed to investigate the effect of acute hip fracture on the recovery of neurological function and the prognosis of patients with acute cerebral infarction, as well as whether surgical treatment of combined acute fracture can improve the prognosis of patients.METHODS:Thirty patients with acute cerebral infarction combined with acute hip fracture, who were hospitalized in two hospitals between January 1, 2013 and December 31, 2019, were included. The patients did not undergo surgical treatment. The control group included patients with common acute cerebral infarction without hip fracture admitted in the same period. The neurological function recovery, hospitalization period, half a year recovery rate, incidence of complications, and one-year mortality rate between the two groups were compared. Eleven patients with acute cerebral infarction combined with hip fracture, who underwent surgical treatment, were selected and compared with those in the non-surgery group.RESULTS:Compared with patients with common acute cerebral infarction, the National Institutes of Health Stroke Scale score of those with acute cerebral infarction combined with hip fracture was higher (7.2±5.4 vs. 5.6%±4.3, p=0.034), the hospitalization period was prolonged (16.1±8.9% vs. 12.2±5.3, p=0.041), and the half a year recovery rate was lower (26.7% vs. 53.3%, p=0.016). Additionally, the incidence of pulmonary infection and lower extremity deep vein thrombosis was increased (30% vs. 11.7%, p=0.03; 6.7% vs. 0, p=0.043). The one-year mortality rate of patients with hip fracture was higher than that of patients with common cerebral infarction (23.3% vs. 6.7%, p=0.027). Compared with the non-surgical group, the good recovery rate after half a year of surgical treatment of the group with cerebral infarction and acute hip fracture had an increasing trend, while the hospitalization cycle, incidence of complications, and one-year mortality rate were all decreased, although this was not statistically significant.CONCLUSIONS:Acute cerebral infarction combined with hip fracture leads to worse neurological recovery, prolonged hospitalization period, increased complications, decreased patient prognosis, and increased one-year mortality. Surgical treatment improves the prognosis of patients with acute cerebral infarction. These findings may provide insights into the management of acute cerebral infarction.

Highlights

  • Hip fractures are a worldwide public health problem with a high incidence among the elderly and an important cause of death and disability in this population

  • We found that fracture after stroke prolonged the hospitalization period of patients and increased the incidence of complications such as pulmonary infection and venous thrombosis, which may increase the risk of death of patients

  • The basic information of 30 patients with acute cerebral infarction combined with hip fracture who did not undergo surgical treatment was recorded, including 15 male patients accounting for 50% of the cohort, with an average age of 81.3±8.4 years

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Summary

Introduction

Hip fractures are a worldwide public health problem with a high incidence among the elderly and an important cause of death and disability in this population. Acute stroke is an important risk factor for hip fracture. Clinical studies have shown that acute stroke in elderly patients is closely related to hip fracture, and the risk of falls is significantly increased because of balance dysfunction and sensory impairment. Ramnemark et al studied 1139 patients with acute stroke and found that the incidence of hip fracture was 2–4 times higher than that of the general population reported in the literature [7]. We found that fracture after stroke prolonged the hospitalization period of patients and increased the incidence of complications such as pulmonary infection and venous thrombosis, which may increase the risk of death of patients. We retrospectively analyzed patients with hip fracture after acute cerebral infarction and discussed the influence of hip fracture on hospitalization period, neurological function recovery, complication rate, and one-year mortality rate of patients with acute cerebral infarction, as well as the influence of surgical treatment of acute hip fracture on patient prognosis

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