Bradeanu Andrei Vlad, Bounegru Iulian, Pascu Loredana Sabina, Ciubara Anamaria, Balseanu Tudor Adrian
Department of Orthopedy and Traumatology, Saint Apostle Andrew Emergency County Clinical Hospital, Galati, Romania.
Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galati, Romania.
Curr Health Sci J. 2024 Jul-Sep;50(3):381-391. doi: 10.12865/CHSJ.50.03.05. Epub 2024 Sep 30.
The aging population is associated with increased osteoporosis and risk of hip fractures. Cognitive decline has recorded exponential increases in the last decades, with the rise in life expectancy.
We conducted a prospective study on 65 patients over 65 years old associated with dementia and hip fractures. We used pre-and post-treatment variables such as age, type of fracture, type of treatment, Charlson Comorbidity Index (CCI), EQ-5D-5L score, and the Harris hip score (HHS) to assess pain, mobility, and mortality. We performed follow-ups at 6 months, 1 year, 2 years, and 3 years.
Patients with dementia typically arrive at the hospital without any previous analgesic treatment and receive lower doses due to poor pain recognition. The 6-month mortality rate was 48.22% and increased to 78.46% at 3 years. The best survival rates were in patients with bipolar prosthesis and Gamma nails, with a 3-year survival rate of 40% and 50%, respectively.
Patients with dementia have a higher mortality rate compared to cognitively intact patients and the treatment decisions require a multidisciplinary team and individualized recommendations for each patient, due to high surgical risk in the elderly.
人口老龄化与骨质疏松症增加及髋部骨折风险相关。在过去几十年中，随着预期寿命的增加，认知能力下降呈指数级增长。
我们对65例65岁以上患有痴呆症和髋部骨折的患者进行了一项前瞻性研究。我们使用治疗前后的变量，如年龄、骨折类型、治疗类型、查尔森合并症指数（CCI）、EQ-5D-5L评分和哈里斯髋关节评分（HHS）来评估疼痛、活动能力和死亡率。我们在6个月、1年、2年和3年进行了随访。
患有痴呆症的患者通常在没有任何先前镇痛治疗的情况下入院，并且由于疼痛识别能力差而接受较低剂量的治疗。6个月死亡率为48.22%，3年时升至78.46%。使用双极假体和伽马钉的患者生存率最高，3年生存率分别为40%和50%。
与认知功能正常的患者相比，患有痴呆症的患者死亡率更高，由于老年人手术风险高，治疗决策需要多学科团队并针对每个患者提供个性化建议。
