Risk prediction in operatively treated fractures of the hip.

Abstract

There have appeared no objective means by which preoperative risk in patients with fractures of the hip can be quantitatively predicted. The developed risk's core is based on medical history, physical examination, chest radiograph, and screening laboratory data. This system reproducibly assigns patients into one of three groups. Three hundred seventeen patients with surgically treated hip fractures (93 femoral head, 166 neck, 58 intertrochanteric fractures) were analyzed in this study. Surgical treatment included 102 Ender-pinnings, 43 Böhler-nails, 79 dynamic hip screws, and 93 endoprostheses of the hip (according to fracture type). Overall mortality rate during hospitalization was 9.5%. The mortality rate in Group I was 2.5%; in Group II, 11.9%; and in Group III, 44.1%. The medical complications in Group I were 12.6%; in Group II, 28.6%; and in Group III, 67.6%. The difference for each group was significant. This preoperative risk assessment appears effective in more accurately identifying patient risk.