Outcome of Early Hip Fracture Surgery in Elderly Patients in Ramathibodi Hospital: A Prospective Cohort Study

Abstract

Background: Early surgery in elderly hip fracture has been recently demonstrated to reduce postoperative mortality and morbidity. However, the result of this strategy is still not established in Asians population or in the patients with multiple co-morbid diseases who required advanced medical care. Objective: To assess the 1-year outcome after treatment with early operative treatment in geriatric patients with hip fracture and compare the outcome between intracapsular and extracapsular hip fracture. Methods: A prospective cohort study was conducted, between 1st January 2011 and 31th December 2011, in all new elderly hip fracture patients. They were enrolled with informed consent and undergone operative treatment within 3 days after admission. Then the patients were prospectively follow-up for one-year period to evaluate the postoperative mortality and morbidity. Results: A total of 106 patients were included. Average age was 79.2\pm8.0 years. Eighty-one patients (76%) had at least two co-morbid disease before fracture. The average length of hospital stay was 7.4\pm4.9 days. The overall mortality rates at 30-day, 90-day, 6-month, and 1-year end point were 2.8%, 5.7%, 7.6%, and 14.3% respectively. Nineteen patients (18.1%) developed complications (46.1%), and re-admission (73.3%). There was no significant difference in one-year mortality and morbidity between intracapsular and extracapsular hip fracture. Conclusions: Early surgery after hip fracture in elderly patients demonstrated effectiveness in reducing postoperative mortality, morbidity, and length of hospital stay, especially in the patients with multiple co-morbidities.