Age as a Determinant of Early Mortality and Disposition after Fractures of the Acetabulum

Abstract

Background: The purpose of our study was to assess the effect of age on early mortality and disposition of patients with acetabular fractures.
Methods: A retrospective chart review from a Trauma Registry at a level one trauma center for all patients admitted with acetabular fractures from July 1993 to March 2001 was carried out.
Results: Data were compared for 42 patients who met the criteria for Group I (mean age 74.7 years) and 489 patients who compromised Group II (mean age 35.1 years). Patients with fatal outcomes, those who required rehabilitation hospital admission, and with conditions that prevented discharge to home were 9.25 (95 % CI 3.74-22.68), 4.07 (95 % CI 2.13-7.71), and 2.78 (95 % CI 1.14-6.72) times more likely to be aged 65 years and above, respectively.
Conclusions: Patients who expired, required rehabilitation/hospital admission, and were unable to be discharged home, were all more likely to be at least 65 years of age.

Key words

Acetabular fracture - functional independence - elderly

References

• 1 Brainsky A, Glick H, Lydick E, Epstein R, Fox K M, Hawkes W, Kashner T M, Zimmerman S I, Magaziner J. The economic cost of hip fractures in community-dwelling older adults: A prospective study.  J Am Geriatr Soc. 1997;  45 281-287
• 2 Cummings S R, Melton L J. Epidemiology and outcomes of osteoporotic fractures.  Lancet. 2002;  359 1761-1767
• 3 Greenspan L, McLellan B A, Greig H. Abbreviated injury scale and injury severity score: A scoring chart.  J Trauma. 1985;  25 60-64
• 4 Haentjens P, Autier P, Barette M, Boonen S. Belgian Hip Fracture Study Group . The economic cost of hip fractures among elderly women.  J Bone Joint Surg [Am]. 2001;  83 493-500
• 5 Henry S M, Pollak A N, Jones A L, Boswell S, Scalea T M. Pelvic fracture in geriatric patients: A distinct clinical entity.  J Trauma. 2002;  53 15-20
• 6 McGwin G, Melton S M, May A K, Rue L W. Long-term survival in the elderly after trauma.  J Trauma. 2000;  49 470-476
• 7 Miller W. Survival and ambulation following hip fracture.  J Bone Joint Surg [Am]. 1978;  60 930-934
• 8 Nightingale S, Holmes J, Mason J, House A. Psychiatric illness and mortality after hip fracture.  Lancet. 2001;  357 1264-1265
• 9 Pellicane J V, Byrne K, DeMaria E J. Preventable complications and death from multiple organ failure among geriatric trauma victims.  J Trauma. 1992;  33 440-444
• 10 Perry D C, DeLong W. Trauma to the adult pelvic and hip.  Orthop Clin N Amer. 1997;  28 405-417
• 11 Plaisier B R, Meldon S W, Super D M, Malangoni M A. Improved outcome after early fixation of acetabular fractures.  Injury. 2000;  31 81-84
• 12 Salkeld G, Cameron I D, Cumming R G, Easter S, Seymour J, Kurrle S E, Quine S. Quality of life related to fear of falling and hip fracture in older women: A time trade off study.  Brit Med J. 2000;  320 341-346
• 13 Scalea T M, Simon H M, Duncan A O, Atweh N A, Sclafani S J, Phillips T F, Shaftan G W. Geriatric blunt multiple trauma: Improved survival with early invasive monitoring.  J Trauma. 1990;  30 129