Abstract
Mortality after hip fractures in the elderly is one of the most important patient outcome measures. Sub-clinical thyroid dysfunction is common in the elderly population. This is a prospective study of 131 elderly patients with a mean (SD) age of 82.0 (8.9) years (range: 61–94) admitted consecutively to our trauma unit. The aim of the study was to determine the prevalence of sub-clinical thyroid dysfunction in an elderly cohort of patients with hip fracture and to determine if this affects the one year mortality.
There were three times more women (n=100) than men (n=31) in this cohort. All patients underwent surgical treatment for the hip fracture. The prevalence of sub-clinical hypothyroidism (TSH > 5.5 mU/L) was15% (n=20) and of sub-clinical hyperthyroidism (TSH < 0.35 mU/L) was 3% (n=4). Overall 18% (n=24) of patients had a subclinical thyroid dysfunction. The twelve month mortality was 27% (n=36).
Age, gender, heart rate at admission, pre-existing Coronary Heart Disease, ASA grade and presence of overt or subclinical thyroid dysfunction were analysed for association with twelve month mortality using a forward stepwise logistic regression analysis. Only ASA grade was found to significantly affect mortality at twelve months (c2 = 3.98, df = 1, p =.046). The presence of sub-clinical hypo or hyper – thyroidism was not associated with a higher mortality (p = 0.278).
We conclude that sub-clinical thyroid dysfunction does not affect the one year mortality in elderly patients treated surgically for hip fracture.
Correspondence should be addressed to Editorial Secretary Mr ML Costa or Assistant Editorial Secretary Mr B.J. Ollivere at BOA, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England; Email: mattcosta@hotmail.com or ben@ollivere.co.uk
