ArticleActa orthopaedica2021
Nonoperative management of hip fractures in very frail elderly patients may lead to a predictable short survival as part of advance care planning.
Article in Acta orthopaedica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Epidemiology, patient outcome and complications after non-operative management of hip fracture: a systematic review.Anaesthesia · 2025Pooled it
- When 'No Surgery' Is Chosen: A Five-Domain Framework for Evaluating Ethical Consent in Non-Operative Hip Fracture Care.Journal of evaluation in clinical practice · 2026Article
- Development and internal validation of prediction model for 90-day mortality in older patients with hip fracture using admission blood parameters.BMC geriatrics · 2026Article
- Beyond pain relief: a thematic exploration of informal caregiver experiences and needs following SPING block treatment in geriatric hip fracture patients.European geriatric medicine · 2026Article
- Intraoperative Traction for Cephalomedullary Nailing in Amputation Patients.Journal of orthopaedic case reports · 2026Article
- The Co-Occurrence of Pertrochanteric Fracture and Acute Coronary Syndrome in a Geriatric Patient: A Case Report and Review of the Literature.Journal of cardiovascular development and disease · 2026Article
- Postoperative mobility is associated with risk of reoperation and increased mortality after hip fracture: a nationwide cohort study of 33,486 patients.Acta orthopaedica · 2026Article
- Defining ceilings of treatment in hip fracture patients: prevalence, prognostic value, and the role of orthogeriatric co-management.European geriatric medicine · 2026Article
- Percutaneous Tibiotalocalcaneal Nailing in Fragility Ankle Fractures of the Elderly: A Single-Center Case Series.Cureus · 2025Article
- Using the Score for Trauma Triage for Geriatric and Middle-aged (STTGMA) to Cluster High-Risk Hip Fracture Patients for Hospice Discharge.Journal of clinical orthopaedics and trauma · 2025Article
- Geriatric Assessment as an Important Tool for Post-Hip Surgery Prognosis in Seniors.Nursing reports (Pavia, Italy) · 2025Article
- Experience with hip denervation in non-operative hip fracture care for frail older patients in the Netherlands: an interview study.BMJ open · 2025Article
- Fragility hip fractures among Nigerian older adults: a retrospective study of epidemiology, mobility and mortality outcomes at 3 and 12 months post-hospital discharge.Archives of osteoporosis · 2025Article
- Exploring the role of systemic inflammation in guiding clinical decision making for geriatric patients with a hip fracture.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Satisfaction and quality of dying with nonoperative end-of-life care for hospitalized and non-hospitalized frail older patients with (suspected) hip fractures: a combined cohort study.Acta orthopaedica · 2025Article
- SPING Block Analgesia in Non-Operative Management of Proximal Femur Fractures in Older Adults Living with Frailty: A Retrospective Cohort Study.Geriatrics (Basel, Switzerland) · 2025Article
- Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures.BMC musculoskeletal disorders · 2024Article
- Patient and proxy perspectives in decision-making for geriatric hip fracture management in the Netherlands: a qualitative study.BMJ open · 2024Article
- Trends in Incidence of Hip Fracture and Hip Replacement in Denmark, 1996 to 2018.JAMA network open · 2024Article
- Palliative Non-Operative Management in Geriatric Hip Fracture Patients: When Would Surgeons Abstain from Surgery?Journal of clinical medicine · 2024Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Surgical treatment is still the mainstay of care even in very frail elderly hip fracture patients. However, one may argue whether surgery is in the best interest of all patients. We elucidated mortality rates of nonoperative management (NOM) of a hip fracture after shared decision-making in a cohort of very frail elderly patients.Patients and methods - Orthogeriatric patients (age > 70 years) admitted with a hip fracture between 2011 and 2019 were included. In the presence of fragility features the motivation for surgery or NOM was supported by advance care planning (ACP) and shared decision-making through geriatric assessment. Mortality rates after NOM were assessed and also presented for the remaining surgical group for reference.Results - In 1,279 out of 3,467 patients, geriatric assessment was indicated and subsequently 1,188 (93%) had surgery versus 91 (7%) NOM. The motivation for NOM was based on patient and family preferences in only 20% of patients, medical grounds in 54%, and a combination of both in 26%. The 30-day and 1-year mortality in the frail NOM group was 87% and 99% respectively, whereas this was 7% and 28% in the surgery group. No statistical comparison between groups was performed due to profound bias by indication.Interpretation - This study provides further insight into the predictable and high short-term mortality after NOM in carefully selected very frail elderly hip fracture patients. This information may help to consider NOM as an alternative treatment option to surgery when no significant gain from surgery is anticipated.
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