Mortality in elderly patients with hip fractures: a retrospective cohort study

Introduction

The purpose of this study is to gather a population of elderly patients with hip fractures who have been through surgery hospitalized in the ICU, and to establish the validity of the APACHE II score as a tool in determining the risk of death.

Methods

A retrospective cohort study was developed. During the period January–December 2003, patients were checked through a revision of medical histories up to the time when they were out of the hospital or up to their death. Initially, 65 patients aged above 60 years were included, an average of 85 (68–98) years, of which 46 (71%) were male. The depending variables were the rate of mortality and the APACHE II score. The APACHE II scale was evaluated by logistic regression procedure with the help of the StatisDirect software 1.617 for Windows. We adopted a level of 5% of probability of rejection of the hypothesis of nullity.

Results

The APACHE II score was 13 (6–28) and the mortality was 9.2% taking into consideration that 25% of the patients had an APACHE II score >16. The length of stay in the ICU was 9.8 (2–38) days. It was observed that the predictive model had a sensitivity of 66.7% and a specificity of 98.3%.

Conclusions

The risk (odds ratio) for elderly patients who had been through hip fracture surgery was 1.4 (1.1–1.7) times greater for a score of APACHE II greater than 16. We consider that the APACHE II score was a valid tool in determining the risk of death in this kind of patient.