Mortality incidence and its determinants after fragility hip fractures: a prospective cohort study from an Egyptian level one trauma center

Abstract

Background: Fragility hip fracture is a common condition with serious consequences. Most outcomes data come from Western and Asian populations. There are few data from African and Middle Eastern countries.
 Objective: The primary objective was to describe mortality rates after fragility hip fracture in a Level-1 trauma centre in Egypt. The secondary objective was to study the causes of re-admissions, complications, and mortality.
 Methods: A prospective cohort study of 301 patients, aged > 65 years, with fragility hip fractures. Data collected included sociodemographic, co-morbidities, timing of admission, and intraoperative,ostoperative, and post-discharge data as mortal- ity, complications, hospital stay, reoperation, and re-admission. Cox regression analysis was conducted to investigate factors associated with 1-year mortality.
 Results: In-hospital mortality was 8.3% (25 patients) which increased to 52.8% (159 patients) after one year; 58.5% of the deaths occurred in the first 3-months. One-year mortality was independently associated with increasing age, ASA 3-4, cardiac or hepatic co-morbidities, trochanteric fractures, total hospital stay, and postoperative ifection and metal failure.
 Conclusion: Our in-hospital mortality rate resembles developed countries reports, reflecting good initial geriatric health- care. However, our 3- and 12-months mortality rates are unexpectedly high. The implementation of orthogeriatric care after discharge is mandatory to decrease mortality rates.
 Keywords: Fragility hip fractures; trochanteric fractures; mortality rate.

Prevalence and Predictors of Hip Fragility Fractures Related Mortality Following Hip Surgery At a Tertiary Medical Centre Based in Sub Saharan Africa

“…proximal femur nailing ( PFN) found to be the most surgical procedure done 114(71.7%), followed with hemiarthroplasty (HA )39(24.5%) the least procedure was girdle stone 1 (0.6%) and 147(92.5%) stayed in the ward for more than 8 days postsurgery .Among patient who were operated 95 (59.7%) manage to show up on post-operative follow up clinic. And 40.3% never return to post-operative follow up clinic this is the different result from study done Egypt where they lost only 54(14.9%) after discharge, 301(84.7%) manage to show up to their postoperative clinic follow up (9,14,15).…”

“…Prevalence of fragility fracture found to be 4.24% it is near similar with study done in Tunisia which was 4.51%. (8) and majority of patient were found to be range 70-89, 128 (56.4%) and more than 90 years were 18(16.27%).Male were 167(73.6%) more predominant gender than female 60(26.4%) this is strange nding since under normal body physiology female are at greater risk of developing osteoporosis and fragility fracture worldwide (9)(10)(11)(12)(13).…”

Editorial: Infectious diseases and NCDs persist despite concerted effort

“…We have several papers on injury: traumatic spinal cord injury and clinical complications; 38 acute kidney injury among medical and surgical in-patients in Ghana; 39 mortality and its determinants after fragility hip fractures from Egypt 40 ; and risk factors for childhood injuries in Tanzania. 41 ending with a study of sports medicine practices for athletes in Uganda.…”