Preexisting dementia is associated with higher mortality rate in patients with femoral neck fracture

• Published in: Aging medicine Vol. 4; no. 1; pp. 12 - 18
• Main Authors: Rajeev, Aysha, Ali, Mohammed, Tuinebreijer, Wim, Zourob, Emadeldeen, Anto, Joseph
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01-03-2021; John Wiley and Sons Inc; Wiley
• Subjects: Age; Alzheimer's disease; Cognition & reasoning; Delirium; Dementia; Diabetes; elderly; femoral neck fracture; Fractures; Medical personnel; Mortality; Original; Patients; prefracture; Surgery; Survival analysis; Vitamin D; Vitamin deficiency; mortality; femoral neck fracture; dementia; prefracture; elderly
• ISSN: 2475-0360; 2475-0360
• DOI: 10.1002/agm2.12142

Objective
This study aimed to assess the mortality and the influence of age, Abbreviated Mental Test (AMT) scores, and American Society of Anesthesiologists (ASA) grades on patients with dementia and femoral neck fracture (FNF) at 30 days, 4 months, 1 year, and 2 years after undergoing surgery.
Methods
Of 1296 patients admitted with FNF, 180 had had prefracture dementia. A retrospective study of these 180 patients was carried out. The patient demographics, including age, sex, presence of diabetes mellitus (DM), lipid profile, AMT score, preoperative comorbidities, ASA grade, and incidence of postoperative delirium, were documented.
Results
A total of 113 patients (62.8%) died postoperatively. The mortality rate was 17.7% (20 patients) at 30 days, 54.9% (62 patients) at 4 months, 77.9% (88 patients) at 1 year, and 87.6% (99 patients) at 2 years. The mortally rate in dementia with FNF was three times higher than that in FNF without dementia and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium.
Conclusions
Dementia should be a principal predictive factor in mortality of FNF and should be a key determinant in all frailty scores.
The mortally rate in dementia with FNF was three times higher than that in FNF without dementia AQ9and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium.