Effect of BMI, Bone Density and Co-Morbidities on the Outcome and Mortality among Elderly Patients (60 Years and Above) Undergoing Surgical Intervention for Fracture Neck of Femur

Background: The incidence of hip fracture varies by age and sex; it is more common in older people. Hip fracture in elderly osteoporotic patients most often results from low-energy trauma such as falling down. Since fracture neck of femur prevalence increases exponentially with age, as population age and longevity increases worldwide, these injuries are likely to occur at accelerated rates. This is important because among those who sustain fracture neck of femur and survive, an increasing number continue to experience various degrees of subsequent disability including a high risk for falls and further injury likewise. The incidence of hip fractures is increasing and the annual number worldwide is estimated to rise from 1.7 million in 1990 to 6.3 million by the year 2050. This will be a major challenge to the health care system and society. Thus, the present study was carried out to analyse the effect of BMI, Bone density and co-morbidities on the outcome and mortality among elderly patients (60 years & above) undergoing surgical intervention for fracture neck of femur. Methodology: An open cohort, prospective study, was conducted in patients with fractures neck of femur (age 60 years and above) presenting to the Department of Orthopaedics, Dr RPGMC Kangra at Tanda and undergoing surgical intervention. All cases presenting to the department and fulfilling the criteria were studied for a period of one year starting from the date of start of the study. Results: 57.1% (n = 486) of the patients were males while remaining 42.9% (n = 36) of the patients were females. Udai Pareek scale showed 35.7% of these patients in class IV while 34.5% patients were in class III. Mean BMI of the patients was 22.33±1.95 Kg/m2 with a range from 18.6 to 26 Kg/m2. Bone density measurement by Singh’s index shows that majority of the patients (32.1%; n = 27) were in grade 4 while 22.6% (n = 19) patients were in grade 6 and 21.4% (n = 18) in grade 5. There were 4 (4.8%) patients in grade 1 and 2. 52.4% (n = 44) had fracture of right femur while remaining 47.6% (n = 40) patents had fracture of left femur. Conclusion: The fracture neck of femur and hip fracture pose a significant risk of mortality and morbidity on the society and need to be focused.