One-year mortality rates and factors affecting mortality after surgery for fracture neck of femur in the elderly

Context: Fractures around hip in elderly are associated with significant morbidity and mortality. Aim: This sudy aims to investigate 1-year mortality rates and risk factors associated with this mortality. Effect of delay in surgery on mortality rates will also be studied. Our null-hypothesis was that there is no association between common comorbid conditions or delay in surgery on 1-year mortality rates. Study Settings and Design: Patients 60-years and above who underwent operative treatment for fracture of neck of femur between January 2018 and February 2019 were included in this retrospective study. Materials and Methods: Demographic and clinical data were collected from hospital information system and inpatient case records. Patients were followed up with quality of life (QoL) assessment with short form-12 (SF-12) at 1 year. Mortality during this period was also evaluated. Statistical Analysis: Continuous factors were expressed as means, standard deviations. Different risk factors between the patients alive and dead were studied using Fisher's exact test. Results: Nineteen out of 95 patients died at the end of 1 year. Smoking, hypertension, diabetes, low hemoglobin, raised total leukocyte count, low serum albumin, delay in surgery (>1 week), higher American Society of Anesthesiologist grade, and postoperative blood transfusion were significantly associated with higher mortality rates. Mean SF-12 QoL scores at 1 year was 35.6 ± 6.3. Conclusion: Hip fractures in elderly are associated with higher mortality rates. Results of this study indicate that patients at a higher risk of mortality may be identified and help in preoperative optimization with the aim to reduce mortality. However, these findings need to be verified by further studies with a relatively larger sample size and longer follow-up period.