Effect of mental state on mortality after hemiarthroplasty for fracture of the femoral neck. A retrospective study of 543 patients.
OBJECTIVE: To assess mortality and functional results of Thompson's hemiarthroplasty for fractured neck of femur in patients with and without senile dementia. DESIGN: Retrospective study. SETTING: District hospital. SUBJECT: 543 Unselected patients who had intracapsular fractures of the femoral neck treated by hemiarthroplasty between 1979 and 1988. MAIN OUTCOME MEASURES: Mortality and functional results during a median follow up period of 14.9 months (range 0.0-111) for patients with senile dementia and 27.4 months (range 0.1-131) for patients who were not demented. RESULTS: 156 of 215 demented patients (73%) died during the follow up period compared with 169 of 328 of those who were not demented (52%). Of the 109 patients with dementia who were mobile before operation only 59 were mobile after operation (54%), compared with 199 of the 215 patients (93%) who were not demented (p < 0.001). Senile dementia seemed to be the only coexisting condition that had a significant effect on mortality. CONCLUSION: Hemiarthroplasty is probably too major an operation with which to treat fractures of the femoral neck in demented patients.