Prediction of Outcome in Patients With Fractures of the Proximal Femur Depending on Medical and Epidemiological and Anamnestic Characteristics

Abstract

The paper shows the results of a study related to the possibilities of predicting the outcome in patients with fractures of the proximal femur depending on the medical-epidemiological and anamnestic characteristics. It was determined that fractures of the proximal femur are among the most common types of fractures and rank third among the most common types of fractures; they have high relevance and medical and social significance. Objective: study the possibilities of predicting treatment outcomes in patients with fractures of the proximal femur depending on the medical-epidemiological and anamnestic characteristics. In order to achieve this purpose, a retrospective study of the treatment outcome in patients with fractures of the proximal femur was conducted using the data of seven medical institutions in Kharkiv for six years (from January 01, 2011 to December 31, 2016). According to the results of the study, a significant direct correlation of healed fractures and healing fractures with a likelihood of surgical treatment was determined: they were 2.40 and 4.15 times higher, respectively, versus the comparison group. A significant inverse correlation with the conservative treatment of pseudarthrosis and other types of lesions, together with fractures of the proximal femur (reduced likelihood of surgical treatment by 79.50% and 66.90%, respectively) was found. There was a significant inverse correlation between age characteristics and the conservative treatment, with 23.10% increase by every 10 years and a direct correlation between functional characteristics according to the ASA classification and surgical treatment. A significant direct correlation of increased likelihood for operative treatment of fractures of all types according to AO classification in comparison with type 31A1 was defined. Significant correlation with the place of residence was established: increased likelihood of conservative treatment (by 75.00% in patients from other cities of Kharkiv region); increased likelihood of surgical treatment (residents of villages of Kharkiv region – 12.78 times, residents of villages of other regions – 5.20 times, residents of cities of other regions – 7.87 times, persons of no fixed abode – 5.11 times). A significant correlation between the characteristics of patients' admission to the clinic and the use of surgical treatment were recorded: in self-treatment (2.29 times) and in referral to outpatient and inpatient facilities (2.44 times). Keywords proximal femur fractures, clinical and epidemiological characteristics, concomitant pathology, comorbid burden, age-sexual characteristics, functional status, odds ratio, confidence intervals.