Morbidity and Mortality following Surgery for Hip Fractures in Elderly Patients

Aim. To determine morbidity and mortality in elderly patients following hip fracture surgery in Egypt and its correlates and to determine the utility of the POSSUM scale to predict morbidity and mortality among our population. Methodology. We assessed postoperative morbidity and mortality following hip fracture surgery in a 6-month prospective observational study of 100 elderly patients who were undergoing surgical repair at the beginning of the study. The exclusion criteria included surgically unfit patients and patients refusing to participate in the study. The study was conducted in Ain Shams University Hospital, Ain Shams Specialized Hospital, and El-helal Hospital. Results. The subjects were categorized as survivors and nonsurvivors according to the 6-month mortality, and the groups were compared statistically according to this classification. The observed 6-month mortality was 19.56%. POSSUM had high specificity for predicting 6-month survival (97.3%). A multivariate regression analysis revealed that postoperative admission to the intensive care unit and lack of ambulation were major risk factors associated with the 6-month mortality. Conclusions. The POSSUM system had high specificity for predicting survivors (97.3%) but failed to predict mortality (sensitivity = 5.6%). The major risks for 6-month mortality are intensive care unit admission and lack of ambulation

Vitamin D status in hospitalized male patients in Ain Shams University Hospitals and relation to body composition

Background Vitamin D deficiency is highly prevalent worldwide; its effect on bone is well known and understood, but the effect of this deficiency is still not clear. Objective This study examines vitamin D status in Egyptian hospitalized elderly male patients and its relation to body composition, muscle strength, and performance. Design This was a cross-sectional study. Participants and methods Data collected from a previous cross-sectional study, in which a systematic random sampling technique was used where every third patient (skip interval) was included in the study and vitamin D was measured only to a selected number of patient who meets inclusion criteria, were selected for inclusion in the study on the basis of the exclusion criteria, which may have affected the parameters measured. Complete assessment of history and physical examination were performed. Measurements Body composition was measured using bioelectrical impedance analysis (Geratherm), hand grip was measured using a Jamar handheld dynamometer, performance was measured using the timed get up and go test, and 25-hydroxyvitamin D was measured by enzyme-linked immunosorbent assay. Results Our study included 88 elderly men 60 years of age or older; the mean age of the participants studied was 64.74 ± 4.6 years, and 86.3% were married, 22.7% were physically active, and 15.9% were nonsmokers. The mean BMI was 26.4 ± 7.2 kg/m2 and the mean vitamin D level was 12.15 ng/ml. The prevalence of vitamin D insufficiency was 19.3% and that of vitamin D deficiency was 79.5%. Vitamin D deficiency was not associated with age, occupation, marital status, smoking (type, duration, and quantity), hand grip, timed get up and go test, and parameters of body composition. Conclusion Vitamin D deficiency and insufficiency is highly prevalent among elderly Egyptian men, and its impact on body composition, muscle function, and strength is not significantly noticeable