Odds of Death Lower With Surgery for Hip Fracture in Patients With Dementia

MONDAY, June 3, 2024 (HealthDay News) -- For community-dwelling patients with dementia and fracture of the femoral head and neck, the odds of death are lower for those treated surgically, according to a study published online May 30 in JAMA Network Open.

Rachel R. Adler, Sc.D., R.D., from Brigham and Women's Hospital in Boston, and colleagues conducted a cross-sectional study to compare outcomes of community-dwelling individuals living with dementia treated surgically and nonsurgically for hip fracture. A total of 56,209 patients were identified with hip fracture: 59.0 and 41.0 percent, respectively, were treated surgically and nonsurgically.

Of the patients treated surgically, 73.3 and 40.2 percent had a fracture of the femoral head and neck and had moderate-to-severe dementia (MSD), respectively. The researchers found that 180-day mortality was 31.8 and 45.7 percent with surgical and nonsurgical treatments, respectively, among patients with MSD and femoral head and neck fracture. The unadjusted and adjusted odds ratios of 180-day mortality were 0.56 and 0.59 among patients with MSD treated surgically versus nonsurgically. For patients with mild dementia and femoral head and neck fracture, 180-day mortality was 26.5 and 34.9 percent, respectively, for surgical and nonsurgical treatments, with unadjusted and adjusted odds ratios of 0.67 and 0.71, respectively. No difference was seen in admission to a nursing home within 180 days for patients with femoral head and neck fracture treated surgically versus nonsurgically.

"These data can help inform discussions around values and goals with patients and caregivers when determining the optimal treatment approach in this population," the authors write.

Several authors disclosed ties to the pharmaceutical and publishing industries.

Abstract/Full Text