%0 Journal Article
%T Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences
%A Alexander A Fisher
%A Wichat Srikusalanukul
%A Michael W Davis
%A Paul N Smith
%J Journal of Trauma Management & Outcomes
%D 2012
%I BioMed Central
%R 10.1186/1752-2897-6-2
%X Prospective evaluation of 761 consecutively admitted patients (mean age 82.3 ¡À 8.8 years; 74.9% women) with low-trauma non-pathological HF. Clinical characteristics and short-term outcomes were recorded. Haematological, renal, liver and thyroid status, C-reactive protein, cardiac troponin I, serum 25(OH) vitamin D, PTH, leptin, adiponectin and resistin were determined.The cervical compared to the tronchanteric HF group was younger, have higher mean haemoglobin, albumin, adiponectin and resistin and lower PTH levels (all P < 0.05). In-hospital mortality, length of hospital stay (LOS), incidence of post-operative myocardial injury and need of institutionalisation were similar in both groups. Multivariate analysis revealed as independent predictors for in-hospital death in patient with cervical HF male sex, hyperparathyroidism and lower leptin levels, while in patients with trochanteric HF only hyperparathyroidism; for post-operative myocardial injury dementia, smoking and renal impairment in the former group and coronary artery disease (CAD), hyperparathyroidism and hypoleptinaemia in the latter; for LOS > 20 days CAD, and age > 75 years and hyperparathyroidism, respectively. Need of institutionalisation was predicted by age > 75 years and dementia in both groups and also by hypovitaminosis D in the cervical and by hyperparathyroidism in the trochanteric HF.Clinical characteristics and incidence of poorer short-term outcomes in the two main HF types are rather similar but risk factors for certain outcomes are site-specific reflecting differences in underlying mechanisms.In elderly people, hip fractures (HFs) are the commonest cause for acute orthopaedic admissions [1] and the second leading cause of hospitalisation and prolonged length of stay (LOS) [2,3]. One of the important challenges in the management of HF is to identify patients who are at high risk of poor outcome.Although HFs dominantly are regarded as homogenous, anatomical types--cervical and trochanteric--d
%K Hip fracture type
%K Clinical characteristics
%K Predictors of outcomes
%U http://www.traumamanagement.org/content/6/1/2