In-Hospital Mortality following Proximal Femur Fractures in Elderly Population

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Public Health

Background:

• Hip fractures are a significant health concern in India, with a crude incidence of 129 per 100,000 in individuals over 50.
• Elderly populations are particularly vulnerable to proximal femur fractures, leading to increased morbidity and mortality.

Purpose of the Study:

• To analyze in-hospital mortality rates in elderly Indian patients experiencing proximal femur fractures.
• To identify key factors influencing mortality, including surgical timing and patient mobility status.

Main Methods:

• Retrospective evaluation of 270 patients aged over 65 with proximal femur fractures at Sri Ramachandra Medical Center, Chennai.
• Exclusion of patients with associated fractures, prior hip fracture history, or malignancies.
• Analysis of surgical delay (over 48 hours) and preoperative mobility (Parker's score) in relation to mortality.

Main Results:

• A total of 24 mortalities were recorded, with 15 males and 9 females.
• In-hospital mortality was associated with low preoperative mobility (16 deaths) and surgical delay exceeding 48 hours (20 deaths).
• Replacement surgeries also showed a higher mortality rate (14 deaths).

Conclusions:

• Low preoperative mobility status, surgical delay beyond 48 hours, and undergoing replacement surgeries are significant predictors of increased in-hospital mortality in elderly patients with proximal femur fractures.
• These findings highlight critical areas for intervention to improve outcomes for this patient group.