Risk factors affecting mortality and patient survival in patients above 60 years undergoing hemiarthroplasty due to hip fracture

Year 2022, Volume: 39 Issue: 2, 369 - 375, 18.03.2022

Kemal Çağlar Duran Recep Dinçer Tolga Atay Vecihi Kırdemir

Abstract

Objective: The aim of this study was to retrospectively determine the risk factors affecting mortality and survival after partial prosthesis treatment of proximal femoral fractures in elderly patients.
Patients and Methots: In this study, patients aged 60 years and over who underwent hemiarthroplasty with the diagnosis of proximal fracture of the femur between 2013 and 2016 were evaluated retrospectively. Those who do not have adequate imaging and cannot be reached
by telephone were not included in the study. 94 patients (58 females and 36 males) were included in the study. Age, gender, fracture type and side, Garden and Evans Scores, Singh Index, ASA values, additional diseases, when they were operated after falling, stem type used,
anesthesia methods, hospitalization periods, survivors Harris hip scores, UCLA scores, Barthel Index and VAS scores a total of 17 parameters were evaluated.
Results: The mean age of the patients was 80.5 (± 6.85); The mean age of the male patients was 78.6 (± 7.51) and the mean age of the female sex was 81.7 (± 6.16). When the fracture types of the cases were examined, it was seen that 58 patients (61%) had intertrochanteric and 36 patients (39%) had collum femoris fracture. The mean time from the day of fracture to operation was calculated as 5.61 (± 11.00). Hypertension, diabetes, and
coronary artery diseases were the most common diseases. Sixty-four out of 94 patients died, and 30 were still alive during our study. It was seen that 11 of the patients died in the first month, 11 of them died between 1-6 months postoperatively, 4 of them died between 6-12 months, 15 of them died between 12-24 months, 23 of them died between 24-60 months. It was seen that 93% (n = 28) of the patients still alive were operated on in the first 5 days after fracture.
Conclusion: Hip fractures are a serious cause of mortality and morbidity in the elderly. Physical and mental capacity of the patients before fracture is one of the most important predictors of postoperative mortality and morbidity. The rehabilitation process of patients who use a large number of drugs due to additional diseases and have a short life expectancy is more difficult than other patients. The main goal is to return patients to their daily lives in the shortest possible time. ASA values and comorbidities were found to be important in postoperative mortality.

Keywords

Aged, comorbidity, hip fractures, mortality, osteoporosis, complications, prognosis, quality of life, risk factors

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