Effect of mental state on mortality after hemiarthroplasty for fracture of the femoral neck. A retrospective study of 543 patients.

OBJECTIVE

To assess mortality and functional results of Thompson's hemiarthroplasty for fractured neck of femur in patients with and without senile dementia.

DESIGN

Retrospective study.

SETTING

District hospital.

SUBJECT

543 Unselected patients who had intracapsular fractures of the femoral neck treated by hemiarthroplasty between 1979 and 1988.

MAIN OUTCOME MEASURES

Mortality and functional results during a median follow up period of 14.9 months (range 0.0-111) for patients with senile dementia and 27.4 months (range 0.1-131) for patients who were not demented.

RESULTS

156 of 215 demented patients (73%) died during the follow up period compared with 169 of 328 of those who were not demented (52%). Of the 109 patients with dementia who were mobile before operation only 59 were mobile after operation (54%), compared with 199 of the 215 patients (93%) who were not demented (p < 0.001). Senile dementia seemed to be the only coexisting condition that had a significant effect on mortality.

CONCLUSION

Hemiarthroplasty is probably too major an operation with which to treat fractures of the femoral neck in demented patients.