Survival and functional outcome in patients 90 years of age or older after hip fracture

摘要

SIR—Epidemiological studies have widely demonstratednthat in industrialised countries, the population is increasinglynageing. Since elderly people can be frail, disabled orndependent [1, 2], this phenomenon will result in significantnsocial and financial burden. Thirty-five per cent of individualsnaged over 65 years fall each year, and up to 10% ofnfalls result in hip fracture [3]. Furthermore, in the elderly,nfalls and hip fracture are the most common causes of acutenhospitalisation producing severe disability [3, 4]. These dramaticnevents are associated with morbidity, mortality, as wellnas poor quality of life [5, 6]. A growing number of peoplenover 90 years of age will suffer from traumatic events andnhip fractures that will need care and rehabilitation treatment,nyet this advanced age is associated with increased mortalitynand poorer functional recovery [7–9]. Several reports [9–16]nin the literature concern the recovery of the ‘oldest old’ [17]nafter hip fracture. However, few studies investigated elderlynpeople aged 90 years or older [11–16] and only one followednthe patients for >1 year [15]. Surgery and rehabilitation cannbe questionable in many of these very elderly [12, 18] who atnthe least may require a different approach as well as an inpatientnsetting for services [19, 20]. The purpose of the presentnstudy was to evaluate functional recovery in nonagenariannpatients with hip fractures. The study focused on (i) functionalnoutcome and recovery of gait after intensive rehabilitationntreatment; (ii) rate of survival and (iii) maintenance ofnwalking and functional ability in patients followed for almostn2 years.