Risk to elderly patients in common hip replacement surgery

A third of elderly patients undergoing a high-risk but common form of hip surgery die within a year.

A paper published in the New Zealand Medical Journal says 32 per cent of elderly patients undergoing surgery to fix a neck-of-femur fracture die within 12 months of surgery. The injury is one of the most common reasons for hospital admissions among the elderly.

The study also found 38 per cent of men in the study, with a mean age of 79 years, and 29 per cent of females, with a mean age of 84 years, died within a year of surgery. The predicted death rate for New Zealand's population at those ages is 7 and 6.4 per cent respectively.

The results were part of the study's assessment of the usefulness of a medical auditing system for a small subgroup of patients.

One of the authors, Christchurch Hospital anaesthesia registrar Dr William Young, said the mortality rates were "certainly significantly higher than the general population, even taking into account age".

The president of the Orthopaedic Association, Dr Russell Tregonning, said in almost all instances, patients with neck-of-femur fractures received surgery.

"It is a measure of the triumph of medicine, modern surgery and anaesthesia that so many of these people actually do survive.

"The alternative is leaving them, and that's really a nasty way to go."

Dr Tregonning said prolonged bed rest in traction used to be prescribed in the distant past for one form of the fracture, but that came with associated problems such as pneumonia, urinary tract infections and bed sores.

Surgery should ideally take place within 48 hours of injury.


DEATH RATES

Of 225 patients in the study (average age 83):

* 12 per cent died within 30 days of surgery.

* 32 per cent were dead within a year.

* The normal predicted death rate at this age is 7 per cent for men and 6.4 per cent for women.