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Consequences of Hip Fracture Among Thai Women Aged 50 Years and Over : A Prospective Study

224

SUTTHICHAI JITAPUNKUL, M.D.*,
PONGSAK YUKTANANDANA, M.D.**

* Department of Medicine,
** Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

Abstract


Objectives : To compare post-discharge outcomes of hip-fractured Thai women aged 50 and over with age and sex-matched controls.

Subjects and method : From 1995 to 1997, 60 Thai women aged 50 years and over with hip fracture who had been admitted to the King Chulalongkorn Memorial Hospital and their age and sex-matched controls (n = 60) were recruited in a case-control study. These 120 patients were followed for at least 1 year after discharge from the hospital by telephone and/or mailed questionnaire to obtain information about outcomes including death, dependency status and new fracture. Relatives of missing subjects were contacted and interviewed about the outcome status of the patients.

Results : The mean age (SD) of those with and without hip fracture was 71.7 (7.6) and 71.2 (8) years, respectively. Of these 120 subjects, 3 cases and 3 controls could not be contacted. The longest follow-up period was 32 months. Means periods (SD) of follow-up among cases and controls were 18.8 (6.7) and 18.1 (6.6) months, respectively. Eleven cases and 5 controls died during the follow-up period. Seven cases and 3 controls died within 1 year after hospitalisation. The survival rate of the cases clealy separated from that of the controls after 1 year. There was a statistical significance of survival between the cases and controls (p < 0.05). The mean (SD) BAI and CAI scores one year after discharge of hip fractured subjects (n = 50) were 17.3 (3.4) and 5.5 (2.3), respectively. The mean (SD) BAI and CAI scores one year after discharge of the control subjects (n = 54) were 16.9 (5) and 5.3 (2.5), respectively. There was no statistically significant difference between dependency status among the two groups. Three (5.2%) cases and one (1.8%) control had new fractures during the follow-up period (no statistical significance).

Conclusion : This study showed that appropriate management of hip fracture could maintain the dependency status of hip-fractured women for one year. However, Thai women aged 50 years and over with hip fracture had a higher mortality rate than those without hip fracture which suggests that hip fracture might be a sign of poor health status among these elderly women.

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