Experts explain what happens after a hip fracture in the elderly

Older people are more vulnerable to fractures due to bone loss. Hip fractures can be extremely serious, often leading to chronic illness and even death. Now experts from the American Geriatrics Society are explaining the real story of hip fractures and how older people are coping after the injury.

This new study indicates that between 18 and 33% of elderly people with hip fractures die in the year, with an even higher incidence of death among people with dementia and those with admitted to nursing homes.

In addition, about half of seniors experience difficulties following a hip fracture, which limits their movements and their ability to perform activities of daily living, including the ability to feed themselves, to wash and dress. As a result, they are mostly confined to bed without being able to move for months, even years after the injury.

X-ray of a hip fracture. Image Credit: Richman Photo / Shutterstock

Because of their physical decline, about 20% of seniors are admitted to retirement homes and retirement homes, and their quality of life deteriorates after a broken hip.

Disabled and immobile patients experience a greater decline after the injury, affecting not only the patient himself, but also the caregivers. Caregivers experience role stress and a financial burden, especially when the patient needs more care.

Despite worrying statistics, there is little research on the number of hours of daily care that people need after a hip fracture. To explore the gap and the problem, the researchers wanted to better understand how older people manage the hip fracture.

The study entitled "Functional findings after hip fracture in independent patients living in the community", published in the Journal of the American Geriatrics Society, shows the overall situation of elderly people with hip fractures. To better understand their situation, the researchers used information from the National Program for the Improvement of the Quality of Surgical Procedures (NSQIP), a program to measure and improve the quality of surgical care.

Through the use of the NSQIP in the Yale New Haven Health System, researchers collected data on patients over 65 years old and having undergone hip fracture surgery in 2015. They chose patients who had new difficulties in achieving their ADL or problems moving into their homes.

The researchers also badyzed the number of hours of daily care received by the caregiver by the patient. A total of 368 participants underwent surgery to repair a hip fracture at Yale New Haven Hospital. Among these, there are 184 participants who were not admitted to retirement homes and those who are able to completely complete their basic activities before the injury.

They followed the path and the life of the participants after the break. Three months after the hip fracture, 21 patients died. At six months, five other patients had succumbed to their injuries.

Of all participants, 18% had depression, 11% had dementia, 21% had congestive heart failure, and 19% had chronic kidney disease.

Researchers say the study shows that having other disorders such as hospital delirium, dementia and the use of drugs can be a predictor of poor results in elderly people with hip fractures, even those who were completely independent before the injury.

In addition, patients who had ADL problems three months after surgery did not improve even after six months. But it's not always the case. Some patients who were unable to walk or move at three months were able to do so six months after the injury, which means that some seniors can improve and recover.

"Overall, this study adds to the current body of literature on hip fracture patients in many ways. We demonstrated the importance of dementia and delirium at the hospital in predicting new or worsened disability in patients who were previously functionally independent, "said the researchers. in the study.

The Centers for Disease Control and Prevention (CDC) report that one of the most serious injuries in the fall is hip fracture because it is difficult to recover from the injury and those who have suffered it will depend on others and can not live alone.

In the United States alone, more than 300,000 seniors are admitted to hospital each year because of hip fractures. In addition, more than 95% of hip fractures are caused by falls. Women have a higher risk of hip fracture and also suffer from osteoporosis, a condition characterized by weakening of the bones, which predisposes them to fractures.