J Korean Med Sci.  2013 Sep;28(9):1378-1381. 10.3346/jkms.2013.28.9.1378.

Poor Prognosis in Elderly Patients Who Refused Surgery Because of Economic Burden and Medical Problem After Hip Fracture

• Yoon BH
• Baek JH
• Kim MK
• Lee YK
• Ha YC
• Koo KH

• KMID: 1793056
• DOI: http://doi.org/10.3346/jkms.2013.28.9.1378

Abstract

Although many studies have assessed mortality and morbidity of conservative treatment after hip fracture in elderly patients, the mortality of conservative treatment done because of economic burden is unclear. Among 451 patients diagnosed with displaced hip fracture during 3 yr, 28 patients (Group I) were enrolled as conservative treatment. Fifty-six patients matched in age, gender, ASA score, and diagnosis (Group II) who had undergone surgical treatment were used as the control group. The causal factors of non-operative treatment and mortality rate and functional recovery were evaluated according to the causal factors of patients with surgical procedure. Ten patients (36%) in Group I involved medical problems and 18 (64%) by economic burdens. The cumulative mortality rate over 3, 6, 12, and 24 months was 54%, 61%, 64%, and 82% in Group I and 9%, 11%, 14%, and 21% in Group II, respectively. At the latest follow-up, all five patients in Group I displayed a nonfunctional ambulatory state, whereas only seven of 44 patients in Group II were in a nonfunctional ambulatory state. Non-surgical treatment following hip fracture that is done because of the economic burden is associated with substantially high mortality and serious functional loss.

Keyword

Hip Fractures; Conservative Treatment; Economic Burden; Mortality; Functional Loss

MeSH Terms

Age Factors
Aged
Aged, 80 and over
Female
Follow-Up Studies
Hip Fractures/diagnosis/mortality/*surgery
Humans
Kaplan-Meier Estimate
Male
Prognosis
Recovery of Function
Severity of Illness Index
Sex Factors
Socioeconomic Factors

Figure

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  Fig. 1 Kaplan-Meier survival analysis comparing surgical control group and non-surgical group.

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