OUTCOME OF HIP-FRACTURES AMONG ELDERLY SUBJECTS

This paper reports a retrospective study (1979-1995) on 200 patients ( 154 women and 46 men), 50-101 years old, who received medical attentio n because of unilateral hip fracture. Nine women and four men fracture d twice. In 75% of women and 90% of men, surgery was carried out betwe en one and five days after fracture. A non significant greater proport ion of women (14/154) than men (6/46) died in the first year after inj ury (chi(2) = 3.459, P = 0.062). Survival was assessed using Cox prope rtional hazards model, Survival was a function of age (P = 0.000) and sex (P = 0.008). After adjustment to a common mean age (79 years), the median survivals for men and women were 3.9 and 8.4 years, respective ly. Controlled concurrent life-threatening diseases, the kind of fract ure [medial (subcapital and transcervical) or lateral (inter-and subtr ochanteric)] and the type of prosthesis (total/partial articulation re placement) had no significant impact on survival. No differences in ev olution were observed: 80% returned to their ambulatory status before injury, 8.5% required walking aids and 5.5% could not walk. The overal l information afforded by this study suggests that with worldwide impr ovement of hip fracture outcome, the cost/effectiveness of surgical tr eatment of hip fracture may become, from the standpoint of public heal th investment, a favorable alternative with respect to cost/effectiven ess of prevention-treatment measures.