Author/Editor		Andoljšek, Matej
Title		Starost kot dejavnik tveganja umrljivosti starostnikov z zlomom stegneničnega vratu
Translated title		Age as a risk factor of mortality in elderly with a fracture of the femoral neck
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 1
Publication year		2003
Volume		str. I-107-9
Language		slo
Abstract		Background. Age (life expectancy) determinates the method of treatment in patients with a fracture of the femoral neck. In retrospective study the autor asked: what is the mortality ofpatients afterprimary operation for a fracture of thefemoral neck, are there differences in mortality among age groups and wheather age could be used to select the method of treatment in patients with a fracture of the femoral neck. Methods and results. From 1984 to 1991 273 patients were operated for a fracture of the femoral neck. Two hundred and five were older than 64 years ("elderly"), and these were included in the study. Among them 24 were 65-69 years old, 85 were in seventies, 88 in eighties and eight in nineties. Fifty of 205 elderly patients died in six months ("early mortality" 2.4%), 64 died in first year (31.2%) and 129 died in five years after injury ("late mortality" - 62.9%). Meanwhile, general one year mortality of elderly was 6.6% for men and 5% for women. Early mortality for 65-69 age group was 16.6% for 70-79 age group 22.3%, for 80-89 age group 26.1% and for > 90 age group 50%. Late mortality was 37.5% 54.1% 75% and 100% by age groups respectively. Stratified statistical analysis showed, that age injluenced late mortality only, whereas all other risk factors (male gender, failed rehabilitation, nursery home status, associated cardiovascular disease, heart failure) injluenced early as well as late mortality. To evaluate age independently of other risk factors, logistic regression analysis was done. Logistic regression analysis showed, that differences in early mortality among 65-69, 70-79 and 80-89 age groups were not significant and that difference in late mortality between 70-79 and 80-89 age group become significant not later than after five years, whereas at follow-up life expectancy for 70-79 age group was ten years for men and twelve for women, and for 80-89 age group five and six years respectively. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Pričakovano trajanje življenja je eno od meril pri izbiri načina zdravljenja zloma stegneničnega vratu (ZSV). V retrogradni analizi je avtorja zanimalo: kakšna je umrljivost starostnikov z operiranim ZSV, ali obstajajo razlike v umrljivosti med starostnimi skupinami, in ali je lahko starost poškodovanca merilo pri izboru načina zdravljenja ZSV. Metode in rezultati. V osmih letih (1984-1991) so na Kirurškem oddelku Splošne bolnišnice Jesenice primarno operirali 273 poškodovancev z ZSV. Skupaj 205 poškodovancev (75,1%) je bilo starejših od 64 let ("starostniki") in ti so bili vključeni v analizo umrljivosti. Med njimi jih je bilo 24 starih 65-69 let ("65-letniki"), 85 70-79 let (70-letniki), 88 80-89 let (80-letniki) in osem starih 90 let in več (90-letniki). Po podatkih Registra prebivalstva Republike Slovenije je do januarja 1997 (minimalna opazovalna doba pet let) umrlo 129 bolnikov; 50 jih je umrlo v {estih mesecih po poškodbi ("zgodnja umrljivost" - 24 4%), 64 v prvem letu (31,2%), 129 v petih letih po poškodbi ("pozna umrljivost" - 62,9%). Zgodnja umrjivost "65-letnikov" je bila 16,6%, 70-letnikov 22,3%, 80-letnikov 26,1% in 90-letnikov 50%. Pozna umrljivost je bila po skupinah 37,5%, 54,1%, 75% in 100%. Stratificirana statistična analiza je pokazala, da je starost vplivala na pozno umr jivost, medtem ko so ostali dejavniki tveganja (moški spol, neuspešna rehabilitacija, domska oskrba, pridružena bolezen srca in ožilja, odpoved srca) vplivali tako na zgodnjo kot pozno umr jivost. Analiza z metodo logistične regresije pa je pokazala, da razlike v zgodnji umrljivosti med "65-", 70- in 80-letniki niso pomembne in da razlike v umrljivosti med 70 in 80-letniki postanejo pomembne šele po petih letih. (Izvleček skrajšan pri 2000 znakih).
Descriptors		FEMORAL NECK FRACTURES FRACTURE FIXATION, INTERNAL OSTEOTOMY HIP PROSTHESIS AGED AGE FACTORS