Mortality and Morbidity in Post-operative Hip Fractures - A Prospective Study

Introduction: Hip fractures have become an increasing health problem throughout the world due to an increase in the aging population [1]. Hip fracture leads to pain and immobilization with numerous complications ranging from delirium to functional loss and even death. Objective: The objective of the study was to study the morbidity and mortality associated with proximal femoral fractures with reference to fracture type (intracapsular and extracapsular) and identify the cause which increases the risk of mortality in postoperative period. Materials and Methods: All patients age more than 60 years of age who underwent surgery for proximal femur fractures from July 2015 to October 2017 at our tertiary care center were studied. A total of 120 patients (70 extracapsular and 50 intracapsular fractures) were included in the study. Patients were assessed at different intervals of follow-up. Mortality was assessed and identified the cause of mortality within 1 year treatment of the hip fracture. To measure the morbidity, we studied - mobility score, dependency on walking aids and degree of residual pain. Results and Observation: In intracapsular fractures mortality was at 1 month (6%) at 6 months (14%) and 1 year (16%) and compared to the extracapsular fractures at 1 month (7%) at 6 months (14%) and 1 year (20%). The most common cause of mortality in 1st year of post-operative period being a cardiovascular disease (41%), followed by respiratory disease (23%), hepatorenal disease (14%), surgical sepsis and cerebrovascular accidents (9% each), and other causes retrauma (4%). Reduction in mobility was observed both in intracapsular fracture (preoperatively 6.78 ± 1.47-5.57 ± 1.4 at 1 year) and extracapsular fracture (preoperatively 6.57 ± 1.41-5.50 ± 1.38 at 1 year). At 1 year, it was more in case of intracapsular fracture as compared to extracapsular fracture. Conclusion: During the 1st year of post-operative period mortality is higher in cases of extracapsular fracture in comparison to intracapsular fracture. Despite the fact that intracapsular fracture was mobilized early postoperatively, they are having less mobility at 1 year point of time, comorbidity such as cardiovascular disease respiratory disease hepatorenal disease, septicemia, and cerebrovascular accident being the major cause of death in there patient.