Citation

Atzmon R, Sharfman ZT, Efrati N, Shohat N, Brin Y, Hetsroni I, Nyska M, Palmanovich E. J. Orthop. Surg. Res. 2018; 13(1): e161.

Affiliation

Department of Orthopaedic Surgery, Meir Hospital Sapir Medical Center, Affiliated with the Tel Aviv University Sackler Faculty of Medicine, Kfar Saba, Israel. ezepalm@gmail.com.

Copyright

(Copyright © 2018, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13018-018-0867-1

PMID

29954421

Abstract

BACKGROUND: Hip fractures are associated with increased cerebrovascular accidents (CVAs) in the first postoperative year. Long-term follow-up for CVA and mortality after hip fracture is lacking. The purpose of this study was to identify risk factors for CVA and follow mortality in hip fractures in a cohort with greater than 2 years follow-up.

METHODS: We compared past medical history of patients with hip fractures to long-term survival and the occurrence of CVA. Past medical history, surgical intervention, CVA occurrence, and death were queried from the electronic medical recorder system. Level of significance was set at p < 0.05 with 95% confidence interval.

RESULTS: Two thousand one hundred ninety-five patients met inclusion criteria. Mean follow-up was 5 years. One hundred ten (5.01%) patients were diagnosed with post-fracture CVA. Forty-one patients had CVA in the first year and 55 patients had CVA between 1 to 5 years after surgery. Among the potential risk factors, hypertension (HTN), atrial fibrillation (AF), and diabetes mellitus (DM) had the highest odds ratio for CVA (OR = 1.885, p value = 0.005; OR = 1.79, p value = 0.012; OR = 1.66, p value = 0.012). The median survival time in patients with CVA was 51.12 ± 3.76 months compared to 59.60 ± 0.93 months in patients without CVA (p = 0.033).

CONCLUSIONS: HTN, AF, and DM are significant risk factors for the occurrence of CVA after hip fracture. The majority of CVAs occur between the first and fifth year postoperatively, and CVA is a negative prognostic factor for postoperative survival.

Language: en

Keywords

Cerebrovascular accident; Hip fracture; Mortality; Stroke