Morbidity and Mortality After Second Hip Fracture With and Without Nursing Care Program

Area of Science:

• Gerontology
• Orthopedic Surgery
• Public Health

Background:

• Hip fractures are a significant cause of morbidity and mortality in the elderly, often leading to reduced mobility and independence.
• A substantial percentage of elderly individuals do not regain their pre-fracture functional status even after one to two years.
• The cumulative incidence of a second hip fracture is notable, emphasizing the need for effective prevention and management strategies.

Purpose of the Study:

• To compare morbidity, mortality, functional outcomes, and recovery patterns between first and second hip fractures in elderly patients.
• To investigate the impact of geriatric nursing care versus home care on functional results and mobility after a second hip fracture.

Main Methods:

• Prospective recruitment of patients with contralateral hip fractures over a three-year period.
• Evaluation of independence, gait aids, rehabilitation type, ASA physical status, Harris Hip Score (HHS), and WOMAC scale at admission and follow-up.
• Analysis of mortality rates and their correlation with the interval between fractures.

Main Results:

• Twenty-seven patients underwent surgery for a second hip fracture, with a mean follow-up of 42.52 months and an average interval of 39.63 months between fractures.
• The mortality rate was 37.03% after the second hip fracture, with a significant correlation between mortality time and the interval between fractures (p=0.028).
• Geriatric nursing care showed no significant improvement in overall functional results compared to home care, but significantly improved mobility after the second fracture (p=0.019).

Conclusions:

• Mortality is elevated in the second year following a second hip fracture, and is strongly correlated with the time interval between fractures.
• Geriatric nursing care may offer a better chance of returning to previous mobility status after a second hip fracture.
• Further research is needed to optimize care strategies for elderly patients experiencing recurrent hip fractures.