MORTALITY IN PATIENTS > 90 YEARS OLD WITH PROXIMAL FEMORAL FRACTURES SUBJECTED TO SURGERY

Abstract

Introduction: Proximal femoral fractures have a high mortality rate among older adults, especially those aged > 80 years. Objective: To analyze predictive factors for hospital or late mortality of patients > 90 years old who showed proximal femoral fracture and subjected to surgery. Methods: The study included data from 230 patients aged > 90 years diagnosed with proximal femoral fracture and who underwent surgery between January and December 2017. The statistical evaluation was performed by multivariate analysis by a logistic regression. The associations were estimated by the odds ratio (OD) and confidence interval (95%). Statistical significance was determined with p < 0.05. Results: Late death occurred in 51.3% (118 patients) of the sample and hospital death in 3.5% (8 patients). Most patients were women (83.5%) and the most common fracture was transtrochanteric (57.0%). There was association between late death and the surgery duration (p < 0.05), and between hospital death and the presence of heart diseases (p < 0.05) or endocrinopathies (p < 0.05). Conclusion: Most patients aged > 90 years with proximal femoral fracture subjected to surgery died in less than one year. Late death was associated with the surgery duration and hospital death was associated with the presence of previous endocrinopathies or heart diseases, and the female gender was a protective factor from this outcome. Level of Evidence III, Retrospective Case-Control Study.

Fratura Transtrocantérica em Idosos: intervalo de tempo entre o trauma e a intervenção cirúrgica

“…Diante disso, é válido ressaltar que a fratura transtrocantérica é aquela que ocorre entre a base do colo femoral até 2,5 cm distal ao trocanter menor (ALEXANDRE M, et al, 2019). Devido ao envelhecimento da população mundial, a incidência desse tipo de lesão tem aumentado consideravelmente e pondera-se que o número de casos de lesão do quadril chegará a mais de 6 milhões de casos anuais até 2050, uma vez que é mais comum em idosos (OLIVEIRA CEN, et al, 2022).…”

“…Outrossim, pacientes com idade igual ou superior a 85 anos são avaliados como um marcador independente, já que a idade elevada aumenta o risco de morte em um ano após a fratura. Logo, além das suas comorbidades, a sua idade prevalece quando se analisa a mortalidade dentro de um curto período de tempo (OLIVEIRA CEN, et al, 2022).…”

Efficacy of surgical intervention over conservative management in intertrochanteric fractures among nonagenarians and centenarians: a prospective cohort study

“…Surgeons and patients are often hesitant to proceed with surgery due to concerns over advanced age and pre-existing comorbidities that may lead to postoperative complications and mortality 9 , 10 . While certain experts 11 , 12 particularly regarding the survival results, have indicated advantages, there is concern 13 – 17 among certain research that high proportion of complication rates after surgery were observed whether they had been treated surgically or conservatively. Due to multiple comorbidities, leaving hip fractures untreated can result in 1-year mortality rates of over 60% for nonagenarians and centenarians, as well as other adverse outcomes including longer length of hospital stay (LOS), frequent readmissions, and increased rates of mortality and complications 18 , 19 .…”