Predicting life expectancy after geriatric hip fracture: A systematic review

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Evidence-Based Medicine

Background:

• Displaced femoral neck fractures in the elderly are commonly managed with hemiarthroplasty or total hip arthroplasty.
• Treatment choice depends on life expectancy, as benefits of these procedures may emerge after two years.
• A systematic review assessed literature for predicting survival beyond two years post-hip fracture surgery.

Purpose of the Study:

• To determine if sufficient literature exists to estimate geriatric hip fracture patient life expectancy beyond two years.
• To identify patient variables that influence survival for at least two years post-operatively.

Main Methods:

• Systematic review of PubMed, Embase, and Cochrane databases.
• Inclusion criteria: studies reporting survival data for ≥2 years in ≥100 patients (age ≥65) with isolated hip fractures.
• Analysis of collected variables and reported outcomes in 43 eligible papers.

Main Results:

• 43 studies identified 25 unique variables.
• Age, gender, comorbidities, dementia, and fracture type were collected in most studies.
• Only age and gender data were reported in the majority of results; most variables were reported in ≤5 studies.

Conclusions:

• Significant deficiencies exist in the current literature for evidence-based estimation of 2-year life expectancy in geriatric hip fracture patients.
• Additional data collection, analysis, and reporting are crucial for survival prediction and optimizing treatment strategies.