All-cause mortality risk in aged femoral intertrochanteric fracture patients

J Orthop Surg Res. 2021 Dec 20;16(1):727. doi: 10.1186/s13018-021-02874-9.

Abstract

Introduction: The 1-year mortality rate after femoral intertrochanteric fracture is higher than that of femoral neck fracture, which also belongs to hip fracture (Cui et al. in Arch Osteoporos 14(1):55, 2019). With the application of the concept of co-management model of orthopedics and geriatrics, the short-term and long-term mortality of all types of hip fractures has decreased (Van Heghe et al. in Calcif Tissue Int, 2021, https://doi.org/10.1007/s00223-021-00913-5 ). However, the mortality of Chinese femoral intertrochanteric fracture patients under this model has not been reported in the literatures.

Aim: This paper aims to study the risk factors of postoperative all-cause mortality in aged patients with femoral intertrochanteric fracture under the co-management model of orthopedics and geriatrics.

Materials and methods: This is a single-center prospective cohort study based on the real world, under the co-management of orthopedics and geriatrics, 363 patients aged ≥ 65 years with femoral intertrochanteric fracture were enrolled and followed up for 2-3 years; 52 patients were lost to follow up. Age, gender, body mass index (BMI), history of comorbidities, hip Bone Mineral Density (BMD), fracture history, 25(OH)D level, hemoglobin level, anti-osteoporosis treatment were risk factors to be tested. Kaplan-Meier survival curves and multivariate Cox proportional hazards models were constructed to analyze the impact of factors on all-cause mortality.

Results: (1) Most of the dead patients were older (the mean age was 83.4 years, compared with 79.8 years for surviving patients), with more complications and without anti-osteoporosis medication; gender, pre-fracture history, BMI, total hip BMD, hemoglobin, 25(OH)D had no difference between the dead and the living patients. (2) Elderly patients with Intertrochanteric fracture can benefit from the early treatment of Zoledronic Acid (within 3 days after the operation).

Conclusion: Under the co-management of orthopedics and geriatrics, to Chinese patients with Femoral Intertrochanteric fracture, Doctors should pay more attention to their age and chronic disease, and give anti-osteoporosis treatment if allowed.

Keywords: Femoral intertrochanteric fracture; Mortality; Osteoporosis; Zoledronic acid.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Femoral Fractures
  • Femoral Neck Fractures / complications
  • Femoral Neck Fractures / surgery
  • Femur
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / mortality*
  • Hip Fractures / surgery
  • Humans
  • Male
  • Postoperative Complications / mortality*
  • Prospective Studies
  • Retrospective Studies