Mortality rate of geriatric patients with open ankle fractures

Open ankle fractures can pose a threat to life in the geriatric population, aged 65 years and older. These patients are susceptible to postoperative complications, often related to poor bone mineral density and soft tissue quality. While the mortality rate associated with open ankle fractures in the elderly has been explored, there is a lack of studies addressing mortality outcomes beyond one year. Furthermore, there is an absence of comparison to the general population. Without that comparison, it is difficult to determine whether open ankle fractures are independently associated with an increased mortality risk.

This study aimed to determine the mortality rate of open ankle fractures in geriatric patients and to compare that to the mortality rate of a general geriatric population. Additionally, we aimed to identify potential risk factors associated with increased mortality.

A retrospective review of 115 patients who sustained open ankle fractures at our institution between 2012 and 2024 was performed.

Of these, 41 patients had a documented date of death, and our analysis revealed a 12.0 % mortality rate at 1-year and a 29.2 % mortality rate at 5-years post-surgery. The standardized mortality ratio was calculated to contextualize the observed mortality relative to the expected mortality in the general population after age and sex matching, which showed a higher 1-year mortality rate in our geriatric patients with open ankle fractures compared to the general population.

These findings offer valuable insights for clinicians and highlight the risk faced by this population.