Journal Article

Co-morbidities, complications and causes of death among people with femoral neck fracture – a three-year follow-up study

Stenvall, Michael, Berggren, Monica, Englund, Undis, Gustafson, Yngve, Olofsson, Birgitta

2016

Overview

Background The poor outcome after a hip fracture is not fully understood. The aim of the study was to describe the prevalence of co-morbidities, complications and causes of death and to investigate factors that are able to predict mortality in old people with femoral neck fracture. Methods Data was obtained from a randomized, controlled trial with a 3-year follow-up at Umeå University Hospital, Sweden, which included 199 consecutive patients with femoral neck fracture, aged ≥70 years. The participants were assessed during hospitalization and in their homes 4, 12 and 36 months after surgery. Medical records and death certificates were analysed. Results Multivariate analysis revealed that cancer, dependence in P-ADL (Personal Activities of Daily Living), cardiovascular disease, dementia at baseline or pulmonary emboli or cardiac failure during hospitalization were all independent predictors of 3-year mortality. Seventy-nine out of 199 participants (40 %) died within 3 years. Cardiovascular events (24 %), dementia (23 %), hip-fracture (19 %) and cancer (13 %) were the most common primary causes of death. In total, 136 participants suffered at least one urinary tract infection; 114 suffered 542 falls and 37 sustained 56 new fractures, including 13 hip fractures, during follow-up. Conclusion Old people with femoral neck fracture have multiple co-morbidities and suffer numerous complications. Thus randomized intervention studies should focus on prevention of complications that might be avoidable such as infections, heart diseases, falls and fractures.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Accidental Falls - mortality / Activities of Daily Living / Aged / Aged, 80 and over / Aging / Arthritis / Cardiovascular disease / Cause of death / Cause of Death - trends / Comorbidity / Complications / Complications and side effects / Dementia - complications / Dementia - diagnosis / Dementia - mortality / Electrons / Female / Femoral Neck Fractures - complications / Femoral Neck Fractures - diagnosis / Femoral Neck Fractures - mortality / Follow-Up Studies / Fractures / Geriatrics / Geriatrics/Gerontology / Health aspects / Heart attacks / Hip fracture / Hip Fractures - complications / Hip Fractures - diagnosis / Hip Fractures - mortality / Hip joint / Hospitalization / Hospitalization - trends / Hospitals / Hospitals, University - trends / Humans / Infections / Intervention / Male / Medicine / Medicine & Public Health / Morbidity / Mortality / Nursing / nutrition and epidemiology / Older people / Patient outcomes / Patients / Public health / Rehabilitation / Research Article / Risk factors / Surgery / Sweden - epidemiology / Systemic diseases / Time Factors