Mortality and Prognostic Factors in Intertrochanteric Femur Fractures – Insights From Şanlıurfa

Öz

Background and Objective: Intertrochanteric femur fractures are severe injuries, particularly affecting the elderly population, and are associated with high morbidity and mortality. Early surgical intervention has been reported to reduce these risks, yet regional differences' influence on patient demographics and clinical management remains debatable. Methods: A retrospective analysis was conducted on 305 patients treated for intertrochanteric femur fractures between 2015 and 2020 at Sanliurfa Mehmet Akif Inan Training and Research Hospital. Patients with a radiologically confirmed diagnosis of intertrochanteric femoral fracture, aged 50 years and older, with complete treatment records and follow-up data, were included. Demographic data (age, sex), clinical parameters (age at surgery, ASA score, comorbidities), time from hospital admission to surgery, and follow-up time and mortality status were meticulously collected from patient records. Results: Mortality was observed in 36 patients. No significant differences in mortality were found between the sexes or in postoperative intensive care requirements. However, patients with higher ASA scores and multiple comorbidities exhibited a significantly increased risk of mortality (OR: 1.8, 95% CI: 1.2-2.6, p =0.004). Additionally, A longer time to surgery was observed in the mortality group (28.4 ± 8.3 hours vs. 20.6 ± 6.2 hours, p = 0.002); however, whether this delay itself contributed to mortality or reflected pre-existing medical instability requiring preoperative optimization could not be determined in this retrospective study. Conclusions: This study highlights the importance of early surgical intervention and comprehensive risk assessment in reducing mortality in patients with intertrochanteric femoral fractures. The findings underscore the need for optimized clinical management strategies tailored to regional healthcare conditions to improve patient outcomes.

Anahtar Kelimeler

• Intertrochanteric Femur Fracture
• Mortality
• ASA Score
• Comorbidities
• Early Surgical İntervention

Etik Beyan

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Harran University has granted ethics committee approval with protocol number HRU/25.11.12, and informed consent has been obtained from all participants.

İntertrokanterik Femur Kırıklarında Mortalite ve Prognostik Faktörler – Şanlıurfa'dan Yansımalar

Öz

Arka plan ve Amaç: İntertrokanterik femur kırıkları, özellikle yaşlı popülasyonu etkileyen ciddi yaralanmalardır ve yüksek morbidite ve mortalite ile ilişkilidir. Erken cerrahi müdahalenin bu riskleri azalttığı bildirilmiştir, ancak bölgesel farklılıkların hasta demografisi ve klinik yönetim üzerindeki etkisi tartışmaya açıktır. Yöntemler: Şanlıurfa Mehmet Akif Inan Eğitim ve Araştırma Hastanesi'nde 2015-2020 yılları arasında intertrokanterik femur kırığı nedeniyle tedavi edilen 305 hasta üzerinde retrospektif bir analiz yürütülmüştür. Radyolojik olarak intertrokanterik femur kırığı tanısı doğrulanmış, 50 yaş ve üzeri, tam tedavi kayıtları ve takip verileri olan hastalar çalışmaya dahil edilmiştir. Demografik veriler (yaş, cinsiyet), klinik parametreler (ameliyat yaşı, ASA skoru, eşlik eden hastalıklar), hastaneye yatıştan ameliyata kadar geçen süre, takip süresi ve mortalite durumu hasta kayıtlarından titizlikle toplandı. Bulgular: 36 hastada mortalite gözlendi. Cinsiyetler arasında veya postoperatif yoğun bakım gereksinimlerinde anlamlı bir mortalite farkı bulunmadı. Ancak, daha yüksek ASA skorları ve birden fazla eşlik eden hastalığı olan hastalarda mortalite riski önemli ölçüde artmıştır (OR: 1,8, %95 CI: 1,2-2,6, p = 0,004). Ek olarak, gecikmiş cerrahi müdahale daha kötü sonuçlarla ilişkilendirilmiştir, çünkü mortalite grubunda ameliyata kadar geçen ortalama süre önemli ölçüde daha uzundur (28,4 ± 8,3 saate karşı 20,6 ± 6,2 saat, p = 0,002). Sonuç: Bu çalışma, intertrokanterik femoral kırıkları olan hastalarda mortaliteyi azaltmada erken cerrahi müdahalenin ve kapsamlı risk değerlendirmesinin önemini vurgulamaktadır. Bulgular, hasta sonuçlarını iyileştirmek için bölgesel sağlık koşullarına göre uyarlanmış optimize edilmiş klinik yönetim stratejilerine olan ihtiyacı vurgulamaktadır.

Anahtar Kelimeler

• İntertrokanterik Femur Kırığı
• Mortalite
• ASA Skoru
• Eşlik Eden Hastalıklar
• Erken Cerrahi Müdahale

Kaynakça

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