Demographic Insights into One-Year Mortality Following Proximal Femur Fracture Surgery in India.

Abstract

Introduction: Proximal femur fractures are a significant public health issue and a leading cause of morbidity and mortality in the elderly. It poses a remarkable burden on healthcare resources.

Materials and methods: Records of patients with proximal femur fracture operated during the study period (July 01, 2017-May 31, 2020) in our institution were obtained from hospital management system and analyzed retrospectively.

Results: Out of 1189 patients, 1101 met the inclusion criteria. About 66.21% were intertrochanteric, 28.52% were neck femur, and 5.26% were sub-trochanteric fractures. About 60.85% of patients were female. The mean age was 74.1 ± 9.22 years. Most injuries were domestic falls (89%) and left-sided (55%). The average delay in presentation to the hospital was 2.5 ± 6.62 days with mean length of stay being 11.34 ± 6.22 days and average pre-operative wait being 6.89 ± 3.34 days. Hypertension was the most common comorbid condition associated (45%) followed by diabetes (27%). About 4% also sustained other fractures; most common were distal end radius and proximal humerus fracture. Majority (63.7%) were operated between 3 and 7 days post-admission and the most common surgery performed was osteosynthesis with proximal femoral nail (39.69%). For mortality assessment, 34 patients died during hospital stay, 785 patients could be assessed and 282 were lost to follow-up. In-hospital mortality was 3.08%, 30-day mortality was 8.05% and 1-year mortality was 18.92%.

Conclusion: An integrated multidisciplinary approach with fall prevention awareness should be promoted to decrease the overall morbidity and mortality rate.