MORTALITY AND FUNCTION AFTER SURGICALLY-TREATED HIP FRACTURE IN ADULTS YOUNGER THAN AGE 60

ABSTRACT Objective: Hip fractures in young adults can cause poor functional capacity throughout life because of several complications. The purpose of this study was to prospectively evaluate 1-year mortality and functional outcomes for patients aged 60 years or younger with hip fracture . Methods: We prospectively obtained data for all consecutive patients aged 60 or younger with any type of hip fracture who were treated operatively between 2008 and 2014. After one year, patient outcomes were evaluated according to changes in pain severity, functional status (modified Barthel index), and mortality rate . Results: Of the total of 201 patients, 132 (65.7%) were men (mean age: 41.8 years) and 69 (34.3%) were women (mean age: 50.2 years) (p<0.001). Reduced pain severity was reported in 91.5% of the patients. The mean modified Barthel index was 22.3 in men and 18.6 in women (p<0.001). At the one-year follow-up, 39 cases (19.4%) were dependent on walking aids while only 17 patients (8.5%) used walking aids preoperatively (p<0.001). Seven patients (4 men and 3 women) died during the one-year follow-up period; 2 died in the hospital after surgery . Conclusion: Hip fractures in young adults have a low mortality rate, reduction in pain severity, and acceptable functional outcomes one year after surgery. Level of Evidence II, Prospective Comparative Study.

摘要
研究目的：青年髋部骨折可因多种并发症导致终身功能受损，本研究旨在前瞻性评估60岁及以下髋部骨折患者术后1年的死亡率与功能结局。
方法：本研究前瞻性收集2008至2014年间所有连续纳入的、60岁及以下接受手术治疗的各类髋部骨折患者的临床资料。术后1年，基于疼痛程度变化、功能状态（改良Barthel指数（modified Barthel index））及死亡率对患者结局进行评估。
结果：共计纳入201例患者，其中男性132例（占65.7%，平均年龄41.8岁），女性69例（占34.3%，平均年龄50.2岁）（p<0.001）。91.5%的患者疼痛程度得到缓解。男性患者的平均改良Barthel指数为22.3，女性患者为18.6（p<0.001）。术后1年随访时，39例（19.4%）需借助助行器行走，而术前仅17例（8.5%）使用助行器（p<0.001）。随访1年期间共有7例患者死亡（男性4例，女性3例），其中2例于术后住院期间死亡。
结论：青年髋部骨折患者术后1年死亡率较低，疼痛症状可得到有效缓解，功能结局可接受。证据等级：Ⅱ级，前瞻性对照研究。