Why are hip fractures in the elderly so deadly?

Question

Why are hip fractures in the elderly so deadly?

In: Biology

Answer 1

Hip is a big weight bearing joint so you can’t really walk without it. Takes a very long time to heal and be able to walk around normally again. There’s a lot of complications from being immobile for so long.

When you can’t walk, you’re gonna lay in bed all day. You’ll get pressure ulcers on your butt which can create big wounds that get infected. Pretty difficult to keep poop out of wounds on your butt.

When you can’t move your legs, the blood flow in the leg veins slows down a lot. This causes blood clots (deep vein thrombosis) which can migrate to the lungs (pulmonary embolism) which can be fatal.

When you do try to get around, there is a pretty high chance of falling and breaking something else. If you were already having difficulty walking and therefore fell the first time, well it’s gonna be even harder now.

Lots of old people are a bit confused at baseline. Now they’re in pain and they’ll be even more confused. You have an even more confused person who had trouble walking around and now they have even more trouble walking around.

You’ll be in the hospital for a while, after your first fall and surgery, after you get pressure ulcers, after your pulmonary embolism, after your second fall. You might be in and out of the hospital multiple times in a year. Hospitals have all sorts of bad drug resistant bacteria because that’s where all the sick people go to get their infections treated. Every day you’re in the hospital is another day you can get a pneumonia from a nasty drug resistant bacteria. Every day you’re in the hospital is another day you get a Foley catheter associated UTI.

All of the above basically is a “downward spiral” where the first bad misstep leads to a cascade of multiple more missteps. You can go from a “relatively healthy” old person to super super not good shape very quickly.

There are a lot of statistics floating around that when you break your hip, there’s a 50% chance to die in the next year and it’s due to a combination of all of the above.