Retrospective Analysis of Epidemiological Characteristics of Elderly Hip Fractures

Abstract

Objective:To investigate the epidemiology and mortality rate

of elderly hip fractures which are commonly seen because of

increased life expectancy and osteoporosis.

Materials and Methods: 428 patients, who attended our clinic

and operated because of hip fracture in February 2010 –

May 2015, were included and retrospectively analysed in our

study. The patients, who were younger than 55 years old, operated

from the same hip, had pathologic fracture or periprosthetic

fracture were excluded. The fracture type, gender, age

group, co-morbidities, ASA (AmericanSociety of Anesthesiologists)

risk categories, distribution according to seasons, treatment

choice and operation day, first 3 month and one year

mortality rate of the patients were analysed.

Results: The mean age of the patients was 78.65 (55-100) and

64.49% of patients were female, 35.51% of patients were male.

Type of fracture distributon was as 226 (52.80%) trochanteric

fractures, 178 (41.59%) femoral neck fractures and 24 (5.61%)

subtrochanteric fractures. Hip fractures were mostly (50.47%)

in 75-84 age group. 28 (6.54%) patients attended after high

energy trauma, 400 (93.46%) patients attended after low energy

trauma. 84.58 percent of the patients were categorized as

ASA 3 risk or more than and 233 (53.44%) patients had 2 or

more comorbidities). The patients attended our clinic mostly

in winter and least in summer. A trend to fixation from arthroplasty

were detected in the treatment choice of patients.

In 2011, fixation is preferred as treatment choice in 32.39%

of patients, however in 2015 this rate increased to 77.27%.

Operation day mortality rate of patients was 0.93%; one year

mortality rate was 17,99%. Mortality rates of patients increased

with older age groups, and this increase was statistically

significant.

Conclusion: Epidemiological studies about hip fractures in

Turkish population are inadequate. After this study results,

the demographical risk factors of elderly hip fractures were

described. High mortality rate consistent with literature were

showed. This research’s results will be the guide to prevent hip

fractures in the risky population and a reference for further studies.

Keywords

• Elderly hip fractures,epidemiology

Yaşlılarda Kalça Kırıklarının Epidemiyolojik Özelliklerinin Retrospektif Analizi

Öz

Amaç: Artan yaşam süreleri ve osteoporoz nedeniyle sık karşılaşılan yaşlı kalça kırıklarının, epidemiyolojisini ve mortalite oranlarını araştırmak

Yöntem ve Gereç: Şubat 2010 - Mayıs 2015 yılları arasında kliniğimize başvuran ve ameliyat edilen 428 kalça kırığı olan hasta çalışmaya dahil edildi ve retrospektif olarak incelendi. Ellibeş yaş altı, daha önce aynı bölgeden ameliyat edilmiş, patolojik ve periprostetik kırıklı hastalar çalışma dışı bırakıldı.

Hastaların kırık tipi, cinsiyet, yaş grupları, kırık mekanizmaları, ek hastalıkları, ASA (Amerikan Anestezi Topluluğu) risk kategorileri, kırıkların mevsimlere göre dağılımı, yapılan tedavi yöntemleri ve hastaların ameliyat günü, ilk 3 ay ve 1.yıl mortalite oranları araştırıldı.

Bulgular: Hastalarımızın yaş ortalaması 78,65 (55-100)’ti ve %64,49’u kadın, %35,51’i erkek hastalardan oluşuyordu. Kırık tipi dağılımlarına göre; 226’sı (%52,80) trokanterik kırık, 178’i (%41,59) femur boyun kırığı, 24’ü (%5,61) subtrokanterik kırık şeklinde idi. En çok kalça kırığının görüldüğü yaş grubu; %50,47 ile 75-84 yaş arası bulundu. Yirmisekiz (%6,54) hasta yüksek enerjili travma, 400 (%93,46) hasta düşük enerjili travma sonrasında kalça kırığı ile başvurdu. Hastaların % 84,58’i anestezi tarafından ASA-3 veya daha fazla risk ile kategorize edildi, 233’ü (%53,44) iki ya da daha fazla ek kronik hastalığa sahipti. Hastalar en çok kış, en az yaz aylarında kalça kırıkları ile tarafımıza başvurdular. Hastaların tedavisinde yıllara göre artroplastiye kıyasla tespit tercihinin arttığı tespit edildi. 2011 yılında %32,39 oranında tespit tercih edilirken, bu oran 2015 yılında % 77,27’e ulaştı. Hastaların ameliyat günü mortalite oranı % 0,93; bir yıllık mortaliteleri %17,99 olarak bulundu. Hastaların mortalite oranlarının yaş grupları ile istatiksel olarak anlamlı şekilde arttığı görüldü. (p<0,05)

Sonuç: Kalça kırıklarının epidemiyolojisi ile ilgili Türk toplumu araştırma sayısı yetersizdir. Bu çalışma bulguları sonrasında yaşlı kalça kırıklarının demografik olarak risk faktörleri belirlendi. Yaşlılarda kalça kırıklarının literatür ile uyumlu olarak yüksek mortalite riski olduğu gösterildi. Elde edilen bulgular riskli popülasyon için gerekli önlemlerin alınmasında yol gösterici olacak, ileri çalışmalar için bir referans olacaktır.

Anahtar Kelimeler

• Yaşlı kalça kırıkları,epidemiyoloji

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