MORTALITY AND FUNCTIONAL RECOVERY AFTER HIP FRACTURE IN OBESE PATIENTS

Abstract

Introduction and purpose: A large amount of studies discuss risk factors that lead to higher mortality and a worse functional recovery in patients who sustain a hip fracture, namely age, a previous pathology and gender. The purpose of this study is to determine what role is played by obesity in the evolution of this pathology.

Materials and methods: This is a prospective study that includes all the patients older than 65 who were admitted to our hospital for a non-pathological hip fracture between 1999 and 2002. Of a total 1142 patients, 15.5% were obese (BMI> 30). No differences were detected as to the type of fracture, time to surgery or length of hospitalization. The group of obese patients required fewer postoperative blood transfusions since their postop hemoglobin levels were significantly higher than those of the other group. All patients were followed up for up to six months after having sustained the fracture or until exitus.

Results: Mortality was 24% for the control group and 39.1% for obese patients. Significantly, this group also had a higher complications rate (pneumonias, deep venous thrombosis, pulmonary thromboembolism and digestive bleeding). Lastly, functional recovery took significantly less time.

Conclusions: Vital and functional prognosis after sustaining a hip fracture is bleaker for obese patients. In our study we quantified it at a RR = 1.62 for mortality and at a RR=2.01 for poor functional recovery. The higher frequency of postop complications lead us to indicating more stringent prophylactic measures for these patients.