Analysis of the length of survival and duration of hospital stay of patients with pertrochanteric femoral fracture (AO 31A1-A3).

BACKGROUND

Surgery is the method of choice in patients with pertrochanteric femoral fractures. The aim of the study was to analyse the length of survival and duration of hospital stay of patients versus operative technique and selected prognostic factors, i.e.: changes in hemoglobin (Hg) levels, hematocrit (Ht), as well as age and gender.

MATERIAL AND METHODS

The subjects of this study were 403 patients with pertrochanteric femoral fractures who were operated on in the period 2005-2008. Information on age, gender, the type of fracture and laboratory parameters was acquired from patient case histories. Dates of death were obtained from the Statistical Office. We analysed the survival rate using Kaplan-Meier's method with Cox's F test and performed a multidimensional dependency analysis of survival (Cox regression model) with Spearman's rank correlation coefficient, and we also used the above-mentioned tests to conduct a regression analysis of the duration of hospitalization.

RESULTS

255 patients (63%) underwent DHS fixation, while 108 (27%) were treated with Gamma nails, and 40 (10%) with angled condylar plates. The operative technique and gender were not significantly associated with the predicted length of survival. Factors with an inversely proportional effect on the predicted length of survival comprised age, the difference between admission and postoperative haemoglobin (Hg) levels and the number of pRBC units transfused as a consequence of that difference. The duration of postoperative hospital stay was not significantly related to either the type of implant or gender. The duration of hospital stay was determined by the age of the patient and hemoglobin level on admission.

CONCLUSIONS

1. Significant prognostic factors predicting the survival time of patients with pertrochanteric femoral fractures comprise: age, a decrease in Hg levels, and the number of pRBC units transfused during the treatment. 2. The duration of hospital stay depends ultimately on patient age and Hg level on admission. 3. The operative technique and gender have no significant prognostic value regarding the length of survival and duration of hospital stay.