Abstract
PurposeOrthogeriatric trauma patients are at risk for functional decline and mortality. It is important to identify high-risk patients in an early stage, to improve outcomes and make better informed treatment decisions. The aim of this study was to identify independent risk factors for 30-day mortality in patients aged 85 years or above admitted from the emergency department with a fracture.MethodsAll orthopaedic trauma patients 85 years or above admitted from the emergency department were included. After a 30-day follow-up, mortality was determined by consulting the patient records. Multivariable logistics regression analysis generated odd ratios for mortality risk factors. A subgroup analysis was performed for patients undergoing hip fracture surgery.ResultsThe 30-day mortality in geriatric fracture patients admitted to the hospital was 12%. Risk factors for 30-day mortality were: increased age, male sex, decreased hemoglobin levels, living in an institutional care facility and a decreased BMI. For geriatric patients undergoing hip fracture surgery 30-day mortality was 11%. Independent risk factors for this group were: increased age, male sex, and a decreased BMI.ConclusionOrthopaedic trauma patients aged 85 years or above who are admitted to the hospital with a fracture are at high risk for mortality. This study identified older age, male sex, and decreased BMI as predictors of 30-day mortality in admitted geriatric fracture patients and in geriatric hip fracture patients undergoing surgery.
Highlights
Life expectancy is rising, and older orthopaedic trauma patients presenting to the emergency department (ED) are becoming a bigger part of the workload for orthopaedic surgeons [1]
This study shows that 30-day mortality in geriatric patients admitted to the hospital with a fracture is high, regardless of treatment (12%)
This study shows that all older orthogeriatric trauma patients who are admitted to the hospital with a fracture have a high risk (12%) of 30-day mortality, regardless of treatment
Summary
Patients aged 85 years or above constitute the fastest growing age group and are at even higher risk for postoperative complications and death than the general geriatric population [4,5,6,7]. These geriatric fracture patients are a distinct age group with considerable risk of negative medical outcomes. There is need for more research targeting this age group to identify risk factors for negative medical outcomes, which is why this study will exclusively target patients 85 years or above.
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