Predictive Factors of Death after Surgery for Treatment of Proximal Femoral Fracture

Antunes, Jurandir; Silva, Armando D’Lucca de Castro e; Mendes, Adriano Fernando; Pereira, Felipe Jader Coelho; Oppe, Igor Gerdi; Loures, Elmano de Araújo

doi:10.1055/s-0039-1692179

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Revista Brasileira de Ortopedia

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Sumário

Original Article • Rev. bras. ortop. 54 (04) • Jul-Aug 2019 • https://doi.org/10.1055/s-0039-1692179 copy

Predictive Factors of Death after Surgery for Treatment of Proximal Femoral Fracture^* * Work performed at the Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate predictive factors of death in patients aged ≥ 70 years old with proximal femoral fracture (PFF) submitted to surgical treatment.

Methods

An analysis of medical records by creating a retrospective cohort with a 6- month follow-up. A total of 124 charts were analyzed after applying the inclusion and exclusion criteria. All of the patients were treated by a single orthopedic surgeon under uniform conditions.

Results

The mortality rate was of 34.7%, and the most common profile was female, 85 years old, and with at least 1 comorbidity. Patients > 85 years old, hospitalized for > 7 days, with at least 1 comorbidity, and staying at the intensive care unit (ICU) had a higher risk of death (2, 2.5, 4, and 4 times higher, respectively).

Conclusion

Regarding the death outcome, although we did not find a statistically significant difference in the topography of the lesion and in its behavior in its coexistence with ICU hospitalization, we believe that further investigations under this perspective are required in a population with the studied profile.

Keywords:
hip fractures; mortality; elderly

Variables	n	%
Number of patients	124	100.0
Gender (female)	87	70.2
Age group (> 85 years old)	56	45.2
Hospitalization period (> 7 days)	54	43.5
Number of comorbidities
0	23	18.5
1	40	32.3
2	35	28.2
3	20	16.1
4	6	4.8
Topography
FIT	78	62.9
FNF	46	37.1
ICU Admission (yes)	51	41.1
Outcome (death)	43	34.7

Variable/category	Deaths		p-value	OR	95%CI
Variable/category	n	%	p-value	OR	95%CI
Gender
Male	14	37.80	–	–	–
Female	29	33.30	0.630	0.82	0.37–1.83
Age group
≤ 85 years old	18	26.50	–	–	–
> 85 years old	25	44.60	0.030^* Significant differences at χ2 test (p< 0.05).	2.24	1.705–4.76
Hospitalization period
≤ 7 days	18	25.70	–	–	–
> 7 days	25	46.30	0.020^* Significant differences at χ2 test (p< 0.05).	2.49	1.17–5.31
Comorbidities
No	3	13.00	–	–	–
Yes	40	39.60	0.020^* Significant differences at χ2 test (p< 0.05).	4.37	1.22–15.68
ICU Admission
No	16	21.90	–	–	–
Yes	27	52.90	< 0.001^* Significant differences at χ2 test (p< 0.05).	4.01	1.84–8.75
Topography
FIT	24	30.80	–	–	–
FNF	19	41.30	0.230	1.58	0.74–3.38

Variable	Parameter estimation	Standard error	p-value	Odds Ratio (95%CI)
Age	0.068	0.033	0.039	1.07 (1.00–1.14)
Hospitalization > 7 days	0.631	0.427	0.140	1.88 (0.81–4.34)
FNF	0.502	0.426	0.239	1.65 (0.72–3.81)
ICU Admission	1.106	0.426	0.009	3.02 (1.31–6.96)
Intercept	- 7.421	2.856	0.009	0.001

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence
Jurandir Antunes Filho, MSe, Rua Frederico Lage, n° 75-Mariano Procópio - Juiz de Fora - Minas Gerais, 36080110, Brazil (e-mail: drjurandirantunes@gmail.com).

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Predictive Factors of Death after Surgery for Treatment of Proximal Femoral Fracture* * Work performed at the Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Predictive Factors of Death after Surgery for Treatment of Proximal Femoral Fracture^* * Work performed at the Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.