Effect of age, sex, co morbidities, delay in surgery and complications on outcome in elderly with proximal femur fractures

Abstract

Introduction: Intertrochanteric and femoral neck fractures account for nearly 90% of proximal femur fractures. It is customary to use 65 years of age to define the elderly. One year mortality in these elderly patients ranges from 12%-36%. The main objective of this prospective study is to study the effect of age, sex, co morbidities, delay in surgery and complications on outcome in elderly with proximal femur fractures and to identify optimal measures that can be taken to improve outcome in these patients. It was presumed that early surgery within 48 hours after stabilization of co morbid conditions improves outcome in these elderly patients with proximal femur fractures. Materials and Methods: In this prospective study elderly patients with proximal femur fractures were selected, after careful selection with inclusion and exclusion criteria. They underwent surgery after preoperative assessment and followed for up to one year at a tertiary referral centre. Results: Increasing age and male sex are not significant factors affecting outcome. Increasing number of co morbidities (2, 3 or more) is associated with significant increase in mean length of hospital stay (p values .006, and .001), increased incidence in number of complications (p value .008) and mortality (p value .028). Presence of complications is significantly associated with increase in mean length of hospital stay (p values .000, .001), decline in recovery of pre injury mobility status (p value 0.018), increased incidence in number of deaths (p value .01). Delay in surgery more than 48 hours is associated with significant increase in mean length of hospital stay (p value .001) and increased incidence in number of complications (p value .028). Conclusion:Early surgery within 48 hours after stabilization of co morbid conditions is associated with improvement of outcome in elderly patients with proximal femur fractures is proved correct in terms of decreasing mean length of hospital stay and decreasing incidence of number of complications.

Modern Aspects of the Problem of Fractures of the Proximal Femular

“…At the same time, the risk of developing fractures of the proximal femur throughout life among men is about 6.00 %, and among women twice as high -18.00 %; and from the age of 50 the risks for men are about 11.00 % and for women -23.00 %. Among all fractures of the proximal femur, spinal and cervical fractures account for almost 90.00 % [16]. The fracture of the femoral neck is much more common: 75.30-80.20 % against 19.80-24.70 % of spinal fractures.…”