Tradions and surgeon

Abstract

Background and purpose: The patients with proximal hip fractures are usually treated operatively in Western Europe. However in mid-Asia different indications are used to decide whether this patient is suitable for operative treatment and those are related to specific traditions and rules in hospital. The aim of our study was to investigate patients with hip fractures and compare outcome at one year follow-up in operated and non-operated patients groups. Materials and methods: The study included patients older than 50 years with acute hip fracture consecutively collected from 2013 01 01 to 2014 12 31 and treated either operatively or conservatively. Patients were assessed preoperatively and at one year of the follow-up, using questionnaires from National Swedish Hip Fracture Register and Qol-5D. Results: Out of 398 included, 299 were operated (108 males and 191 females with mean age 69 (SD11)) and 99 were refused for surgery (34 males and 65 females with mean age 75 (SD11) years). Before one year follow-up 18% of patients deceased in operated group, compared to 52% in non-operated group, p=0,001. Out of 27 patients in non-operated group for those hip joint function was evaluated at one year follow-up, 11 (41%) were walking independently or using one stick, as compared to 193 (91%) in operated group. Interpretation: Surgeons' decisions and hospital traditions in terms of selecting treatment method in hip fracture patients should be reconsidered taking in to account the differences in death rates and especially in hip joint functions for those patients who survived.