The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

Background Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding r...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2010-07, Vol.468 (7), p.1869-1883
Main Authors: Pereira, Silvia R. M., Puts, Martine T. E., Portela, Margareth C., Sayeg, Mario A.
Format: Article
Language:English
Subjects:
Accidental Falls
Activities of Daily Living
Aged
Aged, 80 and over
Biological and medical sciences
Brazil - epidemiology
Cause of Death
Clinical Research
Comorbidity
Conservative Orthopedics
Diseases of the osteoarticular system
Female
Health Status
Hip Fractures - mortality
Hospitals, Municipal
Humans
Injuries of the limb. Injuries of the spine
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Osteoporosis - mortality
Postoperative Complications
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Recovery of Function
Risk Factors
Sports Medicine
Surgery
Surgical Orthopedics
Survival Rate
Traumas. Diseases due to physical agents
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Summary:Background Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America. Questions/Purpose We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area. Methods Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture. Results Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk. Conclusions Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil. Level of Evidence Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-009-1147-5