Analysis of the Surgical Outcomes in Elderly Patients with Hip Fractures Combined with Hemiplegia

Jinqiang Wang,1 Hongtao Luo,2 Qi Wang,1 Xiaohui Zhu3 1Department of Emergency, Air Force Characteristic Medical Center, Beijing, 100142, People’s Republic of China; 2Department of Orthopaedics, Air Force Characteristic Medical Center, Beijing, 100142, People’s Republic of China; 3Department of Neurosurgery, Emergency Management Department Emergency General Hospital, Beijing, 100028, People’s Republic of ChinaCorrespondence: Hongtao Luo, Department of Orthopaedics, Air Force characteristic Medical Center, Beijing, 100142, People’s Republic of China, Tel +86 13701210368, Email luohongtaolht@126.comObjective: This study aimed to investigate the surgical outcomes in elderly (age ≥ 65) patients with hip fractures combined with hemiplegia and compare them with the surgical outcomes in elderly patients with hip fractures but no hemiplegia.Methods: A total of 761 elderly patients with hip fractures who were treated between January 2013 and December 2019 were enrolled in this study using a retrospective study design. The patients were divided into two groups: a hemiplegia group (77 cases, 10.1%) and a non-hemiplegia group (684 cases, 89.9%). Length of hospital stay, postoperative complications, 30-day and one-year mortalities, and one-year functional status were compared between the two groups.Results: The average length of hospital stay in the hemiplegia group (13.51 ± 10.17 days) was longer than in the non-hemiplegia group (12.60 ± 7.83 days), but the difference was not statistically significant (P = 0.354). The incidence of postoperative complications in patients with hemiplegia (28.6%, 22/77) was higher than in patients without hemiplegia (15.4%, 105/684), and the difference was statistically significant (P = 0.003). The 30-day and one-year mortalities in the hemiplegia group were higher than in the non-hemiplegia group (30 days after surgery: 10.4%, 8/77 vs 4.5%, 31/684; one year after surgery: 29.9%, 23/77 vs 15.2%, 104/684), and the difference was statistically significant (30 days after surgery: P = 0.027; one year after surgery: P = 0.001). One year after surgery, the average activity of daily living score was 56.02 ± 9.63 in the hemiplegia group and 76.89 ± 8.40 in the non-hemiplegia group, and the difference was statistically significant (P = 0.000).Conclusion: Hemiplegia can increase the incidence of postoperative complications and 30-day and one-year mortalities in patients with hip fractures.Keywords: hip fracture, hemiplegia, curative effect, elderly patients, comorbidity, recovery, complications