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NLM Director’s Comments Transcript
Seniors’ Hip Fracture Risks: 08/04/2014

Picture of Dr. Lindberg
Illustration of three seniors riding bicycles
Photo: Courtesy of the National Library of Medicine.

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

Two recent studies published in the Journal of the American Medical Association and JAMA Internal Medicine provide insights into the types of anesthesia given to hip fracture patients as well as the survival rates of nursing home residents who unfortunately break their hip.

The first study found half of nursing home residents who experienced a hip fracture either died or lost the ability to walk on their own during the six months following hip surgery.

The study’s six authors found the nursing home residents, who were most likely to die or become completely disabled, were seniors older than 90 and persons who did not have surgery after a fracture.

While most nursing home residents were able to walk or get around solo before their injury, the researchers found six months after hospitalization for a hip fracture, one in three persons died, including almost half of male patients.

The lead author of the study, a professor at the University of Pennsylvania Perelman School of Medicine, told Reuters Health (and we quote): ‘Patients who had hip fractures had pretty big increases in disabilities across the spectrum’ (end of quote).

The study was based on national information from U.S. Medicare claims and more than 60,000 nursing home residents, who were hospitalized for hip fractures from 2005-2009.

The study’s lead author told Reuters Health the overall findings suggest surgery for many seniors in nursing homes with hip fractures provides better health outcomes than non-surgery.  He added (and we quote): ‘A pretty high fraction of people who didn’t have surgery had much worse outcomes’ (end of quote.).

The second study, which shares several authors with the first, suggested patients after age 50 - who were given a local or regional anesthesia - experienced a slightly lower risk of death and a slightly shorter hospital stay compared to patients who received general anesthesia.

A local or regional anesthesia is given directly to the affected part of the body compared to a broader or general anesthesia.

More specifically, the second study’s five authors found the death rate for hip fracture surgery was 5.3 percent for patients who received a local anesthesia compared to 5.4 percent for patients who received a general anesthesia after 30 days. The study also found hospital stays after hip fracture surgery averaged six days for patients who received a local anesthesia compared to 6.3 days for patients who received a general anesthesia. The authors explain both of these differences are not statistically significant.

The findings in the second study are based on 57,000 patients after age 50 who had hip fracture surgery in the state of New York between 2004-2011.

The authors of the second study imply the differences are sufficient to warrant future monitoring as more data about the outcomes of hip fracture patients who receive anesthesia are available from other states.

About 300,000 hip fractures occur annually in the U.S. Hip fractures are twice as likely to occur for seniors who live in nursing homes compared to peers who live elsewhere.

Meanwhile, a helpful overview of hip fractures is provided by the American Academy of Physicians in the ‘start here’ section of MedlinePlus.gov’s hip injuries and disorders health topic page. The American Academy of Physicians also provides a website about the diagnosis/symptoms of hip problems in the ‘diagnosis/symptoms’ section of MedlinePlus.gov’s hip injuries and disorders health topic page.

MedlinePlus.gov’s hip injuries and disorders health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about hip injuries and disorders as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s hip injuries and disorders health topic page type ‘hip injuries’ in the search box on MedlinePlus.gov’s home page, then, click on ‘hip injuries and disorders (National Library of Medicine).’ MedlinePlus.gov also has a comprehensive health topic page on hip replacement.

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.