Mortality After Hip Surgery Strongly Affected By Age And Gender

Main Category: Bones / Orthopedics
Article Date: 01 Oct 2008 - 5:00 PDT

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A multivariate logistic regression analysis published today in The Journal of Bone and Joint Surgery, British Volume, shows that the variables most strongly associated with post-operative mortality are those that cannot be controlled with pre-operative medical interventions.

The analysis looked at data from the Scottish Hip Fracture Audit, covering a total of 18,817 patients. With such a large sample size the conclusions drawn are highly significant for surgeons attempting to improve mortality rates by introducing new pre-operative medical interventions.

Clearly case-mix variables, such as age, will always be strong factors associated with mortality. However, some surprising outcomes from the analysis are worth exploring in more detail. Firstly, the study found that 'women were found to have significantly lower early post-operative mortality, even after controlling for the effects of differences in the case-mix variables between the genders'. This finding confirms earlier smaller studies which reported that 'men undergoing surgery for fracture of the hip..have increased morbidity and mortality'.

An ongoing area of investigation in medical literature has been the association between timing of surgery for fracture of the hip and peri-operative mortality. Until now the literature has been contradictory, but this study shows that 'both time from fracture to surgery and time from admission to surgery had no significant relationship with early post-operative mortality'. Therefore, while 'from a humanitarian point of view it is favourable to undertake surgery for fracture of the hip as soon as it is medically safe to do so', the suggestion that surgery must take place within 24 hours of admission to improve outcomes has been shown to be false.

Read the full text article.

The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868.

JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott.

The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches.

http://www.jbjs.org.uk

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