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

Brasil

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

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

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^*	2.24	1.705–4.76
Hospitalization period
≤ 7 days	18	25.70	–	–	–
> 7 days	25	46.30	0.020^*	2.49	1.17–5.31
Comorbidities
No	3	13.00	–	–	–
Yes	40	39.60	0.020^*	4.37	1.22–15.68
ICU Admission
No	16	21.90	–	–	–
Yes	27	52.90	< 0.001^*	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

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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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[TFN1] Abbreviations: ICU, intensive care unit; FNF, femoral neck fracture; FIT, intertrochanteric fracture.

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

Abstract

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