The Mortality Rate after Thromboembolism Prophylaxis in the Hip Fracture Surgery
Thanainit Chotanaphuti MD*, Aekachai Jareonarpornwatana MD*, Artit Laoruengthana MD**
Affiliation : * Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand ** Department of Orthopaedics, Faculty of Medicine, Naresuan University, Bangkok, Thailand
Background : Although hip fracture surgery treatments have been improved, the mortality rate remains high
because of a high risk of complications, such as myocardial infarction and venous thromboembolism. Many
studies have identified the benefit of thromboembolism prophylaxis.
Objective : To determine the 1-year mortality rate of thromboembolism prophylaxis and non-prophylaxis after
the hip fracture surgery.
Material and Method: This study is a prospective analytic study. 114 patients who had undergone the hip
fracture surgery between 2004-05 were given follow-up examinations every 3 months for 1 year.
Results : Of the 114 patients, 25 patients (21.9%) have received the medical thromboprophylactic protocol
and 89 patients (78.1%) have not. The 1-year mortality rate was 12.0% (3 cases) and 9.0% (8 cases) in
the thromboprophylactic group and nonprophylactic group, respectively (p = 0.704). The mean age was
significantly older in the deceased group (86.4 year old, SD 12.86) than the non-deceased group (78.0 years
old, SD 8.04) (p = 0.003). The median duration from postoperation to death was 19 weeks after the surgery
(range 0.5- 52 weeks). The causes of death were acute myocardial infarction 3 (27.3%), sepsis 2 (18.2%),
aspiration pneumonia 1 (9.1%), and unknown cause 5 (45.4%).
Conclusion : The overall 1 year mortality rate after surgery of the hip fracture is 9.6% and it is not different
regardless of whether the medical thromboembolism prophylaxis has been established or not. Myocardial
infarction was the most common cause (27.3%). The elderly patient is at a higher risk of mortality in 1 year
after the surgery.
Keywords : Mortality rate, Thromboprophylacxis, Hip fracture
