Very poor prognosis after a conservatively treated hip fracture in the most frail nursing home residents

M. Broekman, J. D. Vos, L. D. Vijlder, M. Brundel
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Abstract

Purpose: In very frail nursing home residents transport to the hospital for diagnostics in case of a suspected hip fracture might be considered too burdensome or not desirable. We aimed to elucidate the prognosis and disease course for this group. Methods: We performed a retrospective cohort study between 2017 and 2020 in a nursing home in the Netherlands. All patients with a suspected hip fracture were eligible. The main exclusion criteria was transport to the hospital for diagnostics. Our primary outcome is survival after one month. Results: 23 patients fulfilled the inclusion criteria. Median age was 84 years. Almost all patients had severe dementia. After one month 20 patients (87%) had died. Median survival was 5 days (interquartile range 3-8). Conclusion: In the most frail nursing home residents with a suspected hip fracture the prognosis is very poor with a median survival of only 5 days.
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非常差的预后后保守治疗髋部骨折在最脆弱的养老院居民
目的:在非常虚弱的养老院居民运输到医院诊断的情况下,怀疑髋部骨折可能被认为太繁重或不理想。我们的目的是阐明该组的预后和病程。方法:我们在荷兰的一家养老院进行了2017年至2020年的回顾性队列研究。所有疑似髋部骨折的患者均入选。主要的排除标准是送往医院进行诊断。我们的主要结果是一个月后的生存。结果:23例患者符合纳入标准。中位年龄为84岁。几乎所有患者都患有严重的痴呆症。1个月后,20例患者(87%)死亡。中位生存期为5天(四分位数范围3-8)。结论:在最虚弱的养老院居民疑似髋部骨折预后非常差,中位生存期仅为5天。
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