Risk factors and prognosis of postoperative stroke in elderly hip fracture patients

Abstract

Objective To investigate the risk factors of postoperative stroke and their effects on the prognosis in elderly hip fracture patients. Methods The clinical records of 753 elderly patients with hip fracture were analyzed who had been admitted to our department from October 2006 to December 2010. They were 503 men and 250 women, 60 to 102 years of age (average, 77.0 years). Seventeen of them(2.3%) had stroke one week postoperation and the other 736(97.7%) did not. The 2 groups were compared in gender, complications and mortality. Logistic regression was conducted to determine the independent risk factors of postoperative stroke in elderly patients with hip fracture. Results There were more females in the stroke group than in the normal group (58.8% versus 41.2%). Most patients who suffered a stroke in the stroke group were complicated with more than 3 internal diseases. History of arrhythmia, history of stoke, intraop-erative abnormal blood pressure were independent risk factors of acute stoke after hip fracture operation in elderly patients (P 0.05). The one-year mortality in the stroke group (35.7%) was significantly higher than in the normal group (9.0%), showing significant difference in survival curve (P< 0.01). Conclusions The risk of stroke within one week postoperation must not be neglected in elderly hip fracture patients. History of arrhythmia, history of stoke, and intraoperative abnormal blood pressure are independent risk factors of acute stoke after hip fracture operation in elderly patients. Patients who suffer a stroke the first week after operation usually have prolonged hospital stay, increased risk of infection, poor short-term and long-term prognosis. Key words: Aged; Hip; Fractures, bone; Stroke; Functional recovery