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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 01-07-2017 | Original Article • HIP - FRACTURES

The influence of cognitive status on outcome and walking ability after hemiarthroplasty for femoral neck fracture: a prospective cohort study

Authors: Sebastian Mukka, Björn Knutsson, Ferid Krupic, Arkan S. Sayed-Noor

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2017

Abstract

Introduction

Femoral neck fracture (FNF) is a devastating injury with serious medical and social consequences. One-third of these patients have some degree of impaired cognitive status. Despite this, a high proportion of hip fracture trials exclude patients with cognitive impairment (CI). We aimed to evaluate whether moderate to severe CI could predict walking ability, quality of life, functional outcome, reoperations and mortality in elderly patients with displaced FNF treated with hemiarthroplasty (HA).

Methods

This cohort study included a consecutive series of 188 patients treated with HA for a displaced FNF. Patients were assessed for estimated preoperative and 1 year postoperatively with regard to walking ability, cognitive status, quality of life with EQ-5D and hip function with Harris hip score.

Results

There were 188 patients who met the inclusion criteria. A total of 130 patients were in the control group, and 58 were in the CI group. At 1-year follow-up, 31 patients (24%) had died in the control group and 22 patients (38%) had died in the cognitive impaired group. This difference in reoperation and mortality rate was statistically significant (log-rank test, p = 0.016). The CI had a significantly higher incidence of being non-walker (28 vs. 4%, OR 9.2, p = 0.001). The EQ-5D was higher in the control group, while the Harris hip score was comparable in the two groups.

Conclusions

Moderate to severe CI was associated with a high incidence of non-walking ability, worse quality of life, high mortality and re-operation rate after femoral neck fractures treated with HA.

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Title: The influence of cognitive status on outcome and walking ability after hemiarthroplasty for femoral neck fracture: a prospective cohort study
Authors: Sebastian Mukka
Björn Knutsson
Ferid Krupic
Arkan S. Sayed-Noor
Publication date: 01-07-2017
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2017
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-016-1873-9

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The influence of cognitive status on outcome and walking ability after hemiarthroplasty for femoral neck fracture: a prospective cohort study

Abstract

Introduction

Methods

Results

Conclusions

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Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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