Surgery for hip fracture may decrease mortality in community-dwelling adults with dementia
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Key takeaways:
- Surgery for femoral head and neck fractures was linked with reduced mortality in community-dwelling adults with dementia.
- Mortality rates were compared between patients who had surgery vs. nonsurgical treatment.
Among community-dwelling adults with dementia, surgical intervention of femoral head and neck fractures was associated with decreased mortality compared with nonsurgical treatment, according to published results.
Researchers used Medicare fee-for-service data to perform a retrospective cross-sectional study of 56,209 community-dwelling adults (mean age, 86.4 years) who received surgical intervention (n = 33,142; 59%) or nonsurgical treatment (n = 23,067; 41%) of a hip fracture from Jan. 1, 2017, to June 30, 2018.
Researchers noted surgical intervention was more common among patients with femoral head and neck fractures, while nonsurgical treatment was more common among patients with pertrochanteric or subtrochanteric fractures.
Overall, 40.2% of patients who underwent surgical intervention had moderate to severe dementia, while 42.8% of patients who were treated without surgery had moderate to severe dementia.
Among patients with femoral head and neck fractures and moderate to severe dementia, mortality rates at 180 days were lower for those who underwent surgical intervention vs. nonsurgical treatment (31.8% vs. 45.7%, respectively). Among patients with femoral head and neck fractures and mild dementia, mortality rates at 180 days were lower for those who underwent surgical intervention vs. nonsurgical treatment (26.5% vs. 34.9%, respectively).
Researchers noted no significant differences between surgical vs. nonsurgical treatment for patients with other types of hip fractures.
“Surgery was associated with reduced mortality compared with nonsurgical treatment, but only among community-dwelling people living with dementia who had fractures of the femoral head and neck,” the researchers wrote in the study. “These data can help inform discussions around values and goals with patients and caregivers when determining the optimal treatment approach in this population,” they concluded.
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