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The impact of pre-existing conditions on functional outcome and mortality in geriatric hip fracture patients

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Abstract

Purpose

Due to pre-existing illnesses, elderly hip fracture patients represent a vulnerable patient population. The present study was conducted to investigate the effects of various pre-existing conditions on the outcomes of hip fracture patients.

Methods

A total of 402 surgically treated geriatric hip fracture patients were included in this prospective, single-centre study. Upon admission, patient age, gender and fracture type were documented, among other information. Patients were divided into six groups according to their pre-existing illness (neurological, cardiovascular, respiratory, gastrointestinal, renal or musculoskeletal). Outcomes in all six patient groups were measured using the following outcome parameters: length of hospital stay, mobility, functional results and mortality rate at discharge and at the one-year follow-up examination.

Results

Reduced values for the pre-fracture Barthel index (BI) were detected in patients with neurological (p < 0.001) and kidney-related diseases (p = 0.001). Neurological and kidney-related diseases were associated with reduced values on the BI (p < 0.001; p = 0.002) and Tinetti test (TT) (p < 0.001; p = 0.004) as well as an increased mortality rate (p < 0.001; p < 0.001) at the one-year follow-up. In addition, patients with respiratory (p = 0.004) and gastrointestinal disorders (p = 0.007) had an increased mortality rate in the medium term.

Conclusions

Pre-existing conditions are common among geriatric hip fracture patients. Pre-existing neurological and kidney-related diseases had the highest impact on functional outcomes and mortality rates at the end of acute care and in the medium term. In contrast to pre-existing cardiovascular disease, pre-existing neurological, kidney, respiratory and gastrointestinal disorders were also found to be associated with increased mortality rates in the medium term.

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Authors and Affiliations

  1. Center for Orthopaedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany

    Christopher Bliemel, Benjamin Buecking, Ludwig Oberkircher, Steffen Ruchholtz & Daphne Eschbach

  2. Department of Orthopaedic Trauma, University of Aachen Medical Center, Aachen, Germany

    Matthias Knobe

Authors
  1. Christopher Bliemel
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  2. Benjamin Buecking
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  3. Ludwig Oberkircher
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  4. Matthias Knobe
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  5. Steffen Ruchholtz
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  6. Daphne Eschbach
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Correspondence to Christopher Bliemel.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Bliemel, C., Buecking, B., Oberkircher, L. et al. The impact of pre-existing conditions on functional outcome and mortality in geriatric hip fracture patients. International Orthopaedics (SICOT) 41, 1995–2000 (2017). https://doi.org/10.1007/s00264-017-3591-2

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  • DOI: https://doi.org/10.1007/s00264-017-3591-2

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