Author:
Postler Anne,Posten Charlotte,Schubert Melanie,Beyer Franziska,Lützner Jörg,Vicent Oliver,Kleber Christian,Goronzy Jens,Kamin Konrad
Abstract
Abstract
Background
Despite improving the management of proximal femur fractures (PFF) with legal requirements of timing the surgery within 24 h, mortality rates in these patients remain still high. The objective of our study was to analyze potential cofactors which might influence the mortality rate within 90 days after surgery in PFF to avoid adverse events, loss of quality of life and high rates of mortality.
Methods
In this retrospective, single-center study all patients with PFF aged 65 years and older were included. We recorded gender, age, type of fracture, surgery and anesthesia, time, comorbidities and medication as well as complications and mortality rate at 90 days. Separate logistic regression models were used to assess which parameters were associated with patients’ mortality. The mortality rate was neither associated with timing, time and type of surgery nor time and type of anesthesia, but with higher age (OR 1.08 per year; 95% CI 1.034–1.128), lower BMI (OR 0.915 per kg/m2; 95% CI 0.857–0.978), higher CCI (OR 1.170 per point; 95% CI 1.018–1.345), dementia (OR 2.805; 95% CI 1.616–4.869), non-surgical complications (OR 2.276; 95% CI 1.269–4.083) and if mobilization was impossible (OR 10.493; 95% CI 3.612–30.479).
Results
We analyzed a total of 734 patients (age ≥ 65 years) who had a PFF in 2019 and 2020 and received surgery. 129 patients (17.6%) died until 90 days at an median age of 89.7 years (range 65–101 years).
Conclusion
The proportion of patients who died until 90 days after surgery is still high. It is less extend influenced by surgical and anaesthesiologic factors than by patient-related factors like age or lower BMI. Physicians should be aware of the importance of avoiding adverse events and the importance of patients’ mobilization to reduce mortality and improve patients’ outcome.
Funder
Universitätsklinikum Carl Gustav Carus Dresden an der Technischen Universität Dresden
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
Reference42 articles.
1. Rupp M, Walter N, Pfeifer C, Lang S, Kerschbaum M, Krutsch W, Baumann F, Alt V. The incidence of fractures among the adult population of Germany: an analysis from 2009 through 2019. Deutsches Ärzteblatt International. 2021;118(40):665.
2. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury. 2018;49(8):1458–60.
3. Mohit B, Marc S. Management of Acute Hip fracture. N Engl J Med 2017, 377(21):2053–62.
4. Liu E, Killington M, Cameron ID, Li R, Kurrle S, Crotty M. Life expectancy of older people living in aged care facilities after a hip fracture. Sci Rep. 2021;11(1):20266.
5. Bundesausschuss G. Richtlinie Zur Versorgung Der hüftgelenknahen Femurfraktur: Erstfassung.