Why are hip fractures in the elderly so deadly?
In: Biology
A lot of these comments are great I will add another important reason for it being deadly in elderly patients is its danger to all patients. Typically with a broken hip you’re talking about a complex fracture which exposes the bones marrow to all kinds of trauma which leads to marrow infections and then death. Another cause could be the major arteries and veins which can be punctured causing a patient to die out to internal bleeding.
It’s just more common with elderly patients because of general clumsiness of the elderly and the weakening of the bones. As well as the typical act of breaking a hip bone being rather traumatic event of falling and all the subsequent damage.
In contrast I’ve literally seen a elderly person shoulder check a door and break a clavicle it was a simple fracture and it just bruised and healed in a month.
Take care of the elderly around you they’re fragile!
Another factor is that breaking a hip generally has a drastic impact on ones ability to move around and get out and socialize, which can have a much greater impact on the elderly who already may have those issues. So it puts them in forced isolation, which can cause depression impacting other areas.
Because of 2 things, 1) Loss of mobility. This puts them at very high risk for a lot of conditions like loss of muscle strength (use it or lose it… and it’s way harder to recuperate loss of muscle in the elderly), lung infections (not breathing deeply makes the lung not expand as much, something called atelectasis), blood clots (when you don’t move your muscles, you don’t squeeze the blood out of your leg veins and clots can form which can travel to the lung) and something as basic as constipation (a change in diet leads to constipation which can lead to other problems like urinary retention and urinary tract infection). 2) Cognitive decline. When elderly people have some memory problems, every event like infections, trauma, surgery, or even changes in environment (being hospitalized) can further increase confusion and worsen cognitive decline which is not always reversible. Elderly people with dementia who undergo general anesthesia don’t always wake up as mentally sharp as before. They seem to lose a bit or a lot of cognitive function. When you become less mentally sharp, you can’t take care of yourself as much and your health further declines.
As an ER nurse I’d like to post here. It’s the fall that starts to end it all. Often times patience break their hip and they may not be found right away. This can lead to a myriad of issues. Dehydration, pressure sores. Surgery is very risky in older age groups although it’s a much easier with hips nowadays. Oftentimes it’s the immobility that leads to pneumonia and sepsis that ends it.
Another thing to take into consideration with all the smart things that have been said is the length of time the person was on the floor for. This can add additional complexities such as rhabdomyolysis (kidney damage) due to a long lie causing muscle breakdown, pressure injuries, hypothermia. These can make recovery for an already frail person longer.
This thread is making me strongly consider bubble wrapping my mid section permanently when I reach 60.
To add to the others hip fractures in general can be pretty serious. There are a load of major blood vessels in the area thay can be punctured and cause you to bleed internally to death and in the worst breaks even blood loss from the broken bones could do it.
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