The journals of gerontology. Series A, Biological sciences and medical sciences · 2018
Hip Fractures in People Older Than 95 Years: Are Patients Without Age-Associated Illnesses Different?
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Barceló Montserrat, Torres Olga, Ruiz Domingo, Casademont Jordi
Аннотация
BACKGROUND: Patients older than 95 years of age can be categorized according to three morbidity profiles: escapers, delayers, and survivors. The aim of this study was to describe the baseline characteristics, in-hospital outcomes, and cumulative mortality of extremely elderly patients admitted with hip fractures and to examine whether there were differences between patients without age-related illnesses (escapers) and others in the same age group (survivors when age-associated illnesses were diagnosed before the age of 80, delayers when these illnesses appeared after the age of 80).
METHODS: A retrospective review of clinical and outcome data of all patients older than 95 years of age admitted with hip fractures.
RESULTS: Two hundred patients older than 95 years were admitted with hip fractures between December 2009 and September 2015. Eighty-six per cent of patients had at least one in-hospital complication. In-hospital mortality was 12.5 per cent; cumulative mortality rates at 30 days, 3 months, and 1 year were 20.3, 30.8, and 50.5 per cent, respectively. There were 15 (7.5%) escaper patients. Compared with other patients with age-related illnesses, they took fewer drugs, had lower Charlson scores, a higher Barthel index score, shorter length of hospital stay, less delay in surgery, and more often required discharge to an in-patient rehabilitation facility. No differences in cumulative mortality were noted.
CONCLUSIONS: Escaper patients had better baseline characteristics, shorter length of hospital stay, and delay in surgery. Nevertheless, their in-hospital and cumulative mortality rates were similar to those of other patients older than 95 years.
METHODS: A retrospective review of clinical and outcome data of all patients older than 95 years of age admitted with hip fractures.
RESULTS: Two hundred patients older than 95 years were admitted with hip fractures between December 2009 and September 2015. Eighty-six per cent of patients had at least one in-hospital complication. In-hospital mortality was 12.5 per cent; cumulative mortality rates at 30 days, 3 months, and 1 year were 20.3, 30.8, and 50.5 per cent, respectively. There were 15 (7.5%) escaper patients. Compared with other patients with age-related illnesses, they took fewer drugs, had lower Charlson scores, a higher Barthel index score, shorter length of hospital stay, less delay in surgery, and more often required discharge to an in-patient rehabilitation facility. No differences in cumulative mortality were noted.
CONCLUSIONS: Escaper patients had better baseline characteristics, shorter length of hospital stay, and delay in surgery. Nevertheless, their in-hospital and cumulative mortality rates were similar to those of other patients older than 95 years.