Effects of older age and multiple comorbidities on functional outcome after partial hip replacement surgery for hip fractures.

AIM To assess clinical factors associated with partial hip replacement surgery failure and to develop a scoring system to predict it before treatment. METHODS This was a historical cohort study of hip fracture cases underwent partial hip replacement in Siaga Raya Hospital, Jakarta between January 1997 and December 2006. Patients' clinical assessment included sex, age at surgery, ambulatory state, the number of underlying disease or comorbidities, hemoglobin and serum albumin levels, type of fracture and elapsed time between the day of fracture and day of surgery. All patients underwent partial hip surgery. Functional outcome after surgery was assessed by Harris' Hip Score (HHS). A score below 80 points was considered poor. Kaplan-Meier curve with log-rank test was deployed and Cox proportional hazard model was performed to identify independent risk factors associated with poor HHS after surgery. RESULTS Harris hip score could be obtained from 123 patients during the study period. The patients' mean age at surgery was 73+/-9.8 years old. Cox regression analysis showed several risk factors for poor HHS after partial hip replacement procedures, i.e. age at surgery 75 years or more, the presence of two or more comorbidities, anemia and Low albumin. In adjusted model, the number of comorbidities, anemia and Low albumin were confirmed to be independent risk factors for poor HHS after surgery. CONCLUSION Our present study showed that several clinical factors could be used to predict poor Harris hip score after partial hip replacement surgery. Independent risk factors were the number of comorbidities, the presence of anemia and low albumin. Further studies are needed to confirm the prediction model in new, prospective cases.