Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital
Abstract Background Despite improving the management of proximal femur fractures (PFF) with legal requirements of timing the surgery within 24 h, mortality rates in these patients remain still high. The objective of our study was to analyze potential cofactors which might influence the mortality rat...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-04733-8 |
| _version_ | 1797273308528377856 |
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| author | Anne Postler Charlotte Posten Melanie Schubert Franziska Beyer Jörg Lützner Oliver Vicent Christian Kleber Jens Goronzy Konrad Kamin |
| author_facet | Anne Postler Charlotte Posten Melanie Schubert Franziska Beyer Jörg Lützner Oliver Vicent Christian Kleber Jens Goronzy Konrad Kamin |
| author_sort | Anne Postler |
| collection | DOAJ |
| description | Abstract Background Despite improving the management of proximal femur fractures (PFF) with legal requirements of timing the surgery within 24 h, mortality rates in these patients remain still high. The objective of our study was to analyze potential cofactors which might influence the mortality rate within 90 days after surgery in PFF to avoid adverse events, loss of quality of life and high rates of mortality. Methods In this retrospective, single-center study all patients with PFF aged 65 years and older were included. We recorded gender, age, type of fracture, surgery and anesthesia, time, comorbidities and medication as well as complications and mortality rate at 90 days. Separate logistic regression models were used to assess which parameters were associated with patients’ mortality. The mortality rate was neither associated with timing, time and type of surgery nor time and type of anesthesia, but with higher age (OR 1.08 per year; 95% CI 1.034–1.128), lower BMI (OR 0.915 per kg/m2; 95% CI 0.857–0.978), higher CCI (OR 1.170 per point; 95% CI 1.018–1.345), dementia (OR 2.805; 95% CI 1.616–4.869), non-surgical complications (OR 2.276; 95% CI 1.269–4.083) and if mobilization was impossible (OR 10.493; 95% CI 3.612–30.479). Results We analyzed a total of 734 patients (age ≥ 65 years) who had a PFF in 2019 and 2020 and received surgery. 129 patients (17.6%) died until 90 days at an median age of 89.7 years (range 65–101 years). Conclusion The proportion of patients who died until 90 days after surgery is still high. It is less extend influenced by surgical and anaesthesiologic factors than by patient-related factors like age or lower BMI. Physicians should be aware of the importance of avoiding adverse events and the importance of patients’ mobilization to reduce mortality and improve patients’ outcome. |
| first_indexed | 2024-03-07T14:42:33Z |
| format | Article |
| id | doaj.art-4222033951d94b3a88dcd2b3502d407c |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-07T14:42:33Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-4222033951d94b3a88dcd2b3502d407c2024-03-05T20:11:43ZengBMCBMC Geriatrics1471-23182024-02-012411910.1186/s12877-024-04733-8Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospitalAnne Postler0Charlotte Posten1Melanie Schubert2Franziska Beyer3Jörg Lützner4Oliver Vicent5Christian Kleber6Jens Goronzy7Konrad Kamin8University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenDepartment of Orthopaedic, Trauma and Plastic Surgery, University of LeipzigUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenUniversity Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital, TU DresdenAbstract Background Despite improving the management of proximal femur fractures (PFF) with legal requirements of timing the surgery within 24 h, mortality rates in these patients remain still high. The objective of our study was to analyze potential cofactors which might influence the mortality rate within 90 days after surgery in PFF to avoid adverse events, loss of quality of life and high rates of mortality. Methods In this retrospective, single-center study all patients with PFF aged 65 years and older were included. We recorded gender, age, type of fracture, surgery and anesthesia, time, comorbidities and medication as well as complications and mortality rate at 90 days. Separate logistic regression models were used to assess which parameters were associated with patients’ mortality. The mortality rate was neither associated with timing, time and type of surgery nor time and type of anesthesia, but with higher age (OR 1.08 per year; 95% CI 1.034–1.128), lower BMI (OR 0.915 per kg/m2; 95% CI 0.857–0.978), higher CCI (OR 1.170 per point; 95% CI 1.018–1.345), dementia (OR 2.805; 95% CI 1.616–4.869), non-surgical complications (OR 2.276; 95% CI 1.269–4.083) and if mobilization was impossible (OR 10.493; 95% CI 3.612–30.479). Results We analyzed a total of 734 patients (age ≥ 65 years) who had a PFF in 2019 and 2020 and received surgery. 129 patients (17.6%) died until 90 days at an median age of 89.7 years (range 65–101 years). Conclusion The proportion of patients who died until 90 days after surgery is still high. It is less extend influenced by surgical and anaesthesiologic factors than by patient-related factors like age or lower BMI. Physicians should be aware of the importance of avoiding adverse events and the importance of patients’ mobilization to reduce mortality and improve patients’ outcome.https://doi.org/10.1186/s12877-024-04733-8Aged, Hip FracturesProximal femur fracturesSurgeryRisk factorsMortalitySurvival |
| spellingShingle | Anne Postler Charlotte Posten Melanie Schubert Franziska Beyer Jörg Lützner Oliver Vicent Christian Kleber Jens Goronzy Konrad Kamin Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital BMC Geriatrics Aged, Hip Fractures Proximal femur fractures Surgery Risk factors Mortality Survival |
| title | Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital |
| title_full | Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital |
| title_fullStr | Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital |
| title_full_unstemmed | Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital |
| title_short | Patients risk for mortality at 90 days after proximal femur fracture – a retrospective study in a tertiary care hospital |
| title_sort | patients risk for mortality at 90 days after proximal femur fracture a retrospective study in a tertiary care hospital |
| topic | Aged, Hip Fractures Proximal femur fractures Surgery Risk factors Mortality Survival |
| url | https://doi.org/10.1186/s12877-024-04733-8 |
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