Hip fractures in nonagenarians: perioperative mortality and survival

The nonagenarian population is increasing yet there is little known about their survival and mortality rates following hip fractures. The aim was to review and evaluate all the nonagenarians who underwent surgery for intra- or extracapsular hip fracture at the Trauma Unit of the Department of Surgery at the Academic Medical Center (AMC) in Amsterdam in the past 20 years. In this retrospective study, 155 nonagenarians sustaining hip fractures between 1982 and 2001 were included and reviewed. In this population there were 128 women (83%) and 27 men (17%). Mortality in women was higher than in men. In men more intracapsular fractures (70%) were diagnosed compared to extracapsular fractures. The opposite, 38% intracapsular and 62% extracapsular fractures were found in women (p=0.002). A trend in higher perioperative mortality for extracapsular fractures and increasing ASA-classification was observed. Mean survival for the whole population, men and women was 756, 544 and 787 days, respectively. This study shows that ASA-II nonagenarians with hip fractures have comparable life expectancy compared to nonagenarians without a hip fracture. Shortening of hospital stay after hip fracture surgery reduces the costs and will benefit the patient.