Key result
In older adults with proximal femoral fractures, the overall mortality rate was 33.1% at a mean follow-up of 33.3 months, with age ≥ 80 years, surgical delay >48 hours, ASA scores 3-4, and proximal femoral plate use identified as significant risk factors.
Why the study?
Proximal femoral fractures commonly cause health deterioration and mortality in the aging population, prompting evaluation of mortality rates, risk factors, and functional outcomes.
What are the mortality rates, risk factors, and functional outcomes in elderly patients with proximal femoral fractures?
Cohort (n=788)
No
What are the mortality rates, risk factors, and functional outcomes in elderly patients with proximal femoral fractures?
In elderly patients with proximal femoral fractures, age ≥80, delayed surgery >48 hours, higher ASA scores, and use of proximal femoral plates are significant risk factors for mortality.
Observational data on proximal femoral fracture outcomes highlight persistent risks in the elderly; leaves open targeted interventions pending prospective trials.
Background: Global prevalence of osteoporosis and fragility fractures is increasing due to the aging population. Proximal femoral fractures are among the most common orthopedic conditions in elderlt that significantly cause health deterioration and mortality. Here, we aimed to evaluate the mortality rates and risk factors, besides the functional outcomes after these injuries. Methods: In a retrospective cohort study, all patients admitted with a femoral neck or intertrochanteric fracture between 2016 and the end of 2018 were enrolled in this study. Medical records were reviewed to include patients over 60 years of age who had a proximal femoral fracture and had a complete medical record and radiographs available. Exclusion criteria included patients with pathological fractures, cancer under active treatment, follow-up loss, and patient access loss. Demographic and clinical features of patients alongside the details of fracture and patient management were recorded and analyzed. In-hospital and post-discharge mortalities at one and 12 months due to included types of fractures were the primary outcome. Modified Harris Hip Scores (mHHS) was the emasure of functional outcome. Results: A total of 788 patients including 412 females (52.3%) and 376 males (47.7%) with a mean age of patients was 76.05 ± 10.01 years were included in this study. Among patients, 573 (72.7%) had an intertrochanteric fracture, while 215 (27.3%) had a femoral neck fracture, and 97.1% of all received surgical treatment. With a mean follow-up of 33.31 months, overall mortality rate was 33.1%, and 5.7% one-month and 20.2% 12-months rates. Analysis of 1-month mortality showed a significant mortality difference in patients operated after 48 hours of fracture (p=0.01) and in patients withAmerican Society of Anesthesiologists (ASA) scores of 3-4 compared to ASA scores of 1-2 (p=0.001). One-year mortality data showed that the mortality rate in femoral neck fractures was lower compared to other types of fracture. Surgical delay of >48 hours, ASA scores of 3-4, and treatment by proximal femoral plate were associated with shorter survival. The overall mean mHHS score was 53.80 ± 20.78. Conclusion: We found several risk factors of mortality, including age ≥80 years, a >48-hour delay to surgery, and pre-operative ASA scores of 3-4 in patients with proximal femoral fracture. Furthermore, the use of a proximal femoral plate was a significant risk factor for mortality and lower mHHS scores.
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Baghdadi et al. (2023) conducted a cohort in Proximal femoral fractures (n=788). Proximal femoral fractures was evaluated on Overall mortality. In older adults with proximal femoral fractures, the overall mortality rate was 33.1% at a mean follow-up of 33.3 months, with age ≥ 80 years, surgical delay >48 hours, ASA scores 3-4, and proximal femoral plate use identified as significant risk factors.
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