Further experience of nonagenarians with hip fractures

Our purpose was to investigate the factors after predictive outcome 3 month s after the injury in terms of mortality and effective independent walking of nonagenarians with hip fracture. A prospective study seas carried out fo r 2 yr in the orthopaedic wards on patients referred to geriatricians. The data were subjected to logistic regression forward stepwise analysis. Eight y-nine patients were included in the study; 55 (61.8%) had a trochanteric f racture and 86 required a surgical procedure. Before the fracture, 83 patie nts (93.3%) were able to walk by themselves or with minimal supervision. Fo rty-three patients (48.3%.) had an American Society of Anaesthesiologists' of III-IV score. The mean number of postoperative complications seas four. Mean hospital stay was 18.2 days. Within 3 months, 19 patients (21.3%) had died and 58 (69%) were living in their previous residence. Thirty-three (50 % of living patients) were able to walk by themselves or with minimal help within 3 months of the fracture. Predictive variables for 3-month mortality were pre-fracture dependence on others for personal toilet and the presence of cognitive impairment. Predic tive variables for independent efficient walking were bowel control and abs ence of cognitive impairment before the fracture, as well as no development of bed sores during hospitalization. These nonagenarian patients with hip fractures show low perioperative morta lity, frequently return to their previous accommodation and present a limit ed recovery of walking ability. (C) 2001 Elsevier Science Ltd. All rights r eserved.