OUTCOME AFTER HIP FRACTURE IN NONAGENARIANS: PRE-MORBID CONDITIONS AND POST-FRACTURE COMPLICATIONS. MORTALITY AND SURVIVAL, ANALYSIS AT A SINGLE INSTITUTION

Methods: Retrospective observational study of 32 patients, older than 90 years, with fractures of the upper extremity of the femur at the University Hospital of Los Andes (Mérida Venezuela), in the period 1998-2003. Identification data, preexisting diseases, fracture classification, laboratory tests, and preoperative days and total hospitalization days were taken upon admission. Between January 2004 and May 2005, the patients who were discharged alive underwent a home visit, with a file prepared for this purpose. None of the deceased had an autopsy performed. Pathological, sub-trochanteric, and violent accident fractures were excluded.

Results: The female / male ratio was 1.7 / 1. Age 90.4 ± 4.19 years (90-105 years), the men were older (95.7 years). The proportion of trochanteric fractures over the cervical ones was 7/1. 68.8% remained hospitalized for less than 15 days. 34.4% were alive at the time of the review. Deaths in the first 6 months amount to 63.2% and 33.3% within the hospital; 45.5% for males and 36.8% for females. Of those operated on in the first five days, the fatality was 67.8%. For trochanteric fractures, mortality was 75% and for cervical ones, 67.5%. Lymphopenia was associated with deaths in 84.2%; T2 diabetes with 36.8%; anemia 89.5% and postoperative mental disorders 61.1%. Pneumonia in 63.2% was the possible cause of mortality.

Conclusion: In this age group, the following could be predictors of mortality: male sex, with trochanteric fractures, with lymphopenia, with anemia, with diabetes and with post-surgery delirium.