Daddimani Ravi M, Madhava Murthy Srinath K, Sharan Prateek M, Patil Arvind D
Department of Orthopaedics, Adichunchanagiri Hospital and Research Centre, Adichunchanagiri Institute of Medical Sciences, Mandya, IND.
Department of Orthopaedics, Shri Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences and Hospital, Dharwad, IND.
Cureus. 2022 Oct 31;14(10):e30951. doi: 10.7759/cureus.30951. eCollection 2022 Oct.
Background Hip fractures occur frequently in the elderly population over the age of 60 years following low-energy domestic falls. The postoperative mortality after hip fracture surgery depends on numerous factors like comorbidities, pre-fall ambulatory status, nutritional status, cognition, and overall physical health. In this context, the physiological age and reserve play a vital role in mortality after hip fracture surgeries. This physiological reserve is measured in terms of "frailty." There are many frailty indices that assess the physiological reserves of an elderly patient. The modified frailty index (MFI) is one of the validated indexes predicting postoperative complications and mortality. So we concluded there is a need to assess the patients with MFI preoperatively, based on which mortality and postoperative complications could be predicted in our patients. Materials and methods We included 100 patients aged more than 60 years with intertrochanteric and neck of the femur fractures, who were managed surgically. We followed the patients for one year and observed the immediate and late complications and mortality at the end of one year. To reduce bias, patients with pathological fractures, revision surgeries, contralateral fractures, high-energy trauma, younger than 60 years of age, and previous proximal femur fracture surgery on the side of injury were excluded from the study. Results The primary objective was to study the correlation between the MFI with one-year mortality. We observe that the MFI score had a significant effect on mortality at one year (p-value = 0.0316). With a unit increase in the MFI score, the odds of death increase by a factor of 1.52. Conclusion There is a strong correlation between MFI with one-year mortality and postoperative complications after hip fracture surgeries in the elderly. This MFI can be used as a preoperative predictive model to predict the mortality and postoperative complications after hip fractures in the elderly. It will also help patients and their caretakers in decision-making and elucidating surgery choices.
60岁以上的老年人在发生低能量家庭跌倒后经常会出现髋部骨折。髋部骨折手术后的术后死亡率取决于多种因素，如合并症、跌倒前的行走状态、营养状况、认知能力和整体身体健康状况。在这种情况下，生理年龄和储备在髋部骨折手术后的死亡率中起着至关重要的作用。这种生理储备是通过“衰弱”来衡量的。有许多衰弱指数可用于评估老年患者的生理储备。改良衰弱指数（MFI）是预测术后并发症和死亡率的有效指标之一。因此，我们得出结论，有必要在术前用MFI对患者进行评估，据此可以预测我们患者的死亡率和术后并发症。
我们纳入了100例年龄超过60岁的股骨转子间骨折和股骨颈骨折患者，这些患者接受了手术治疗。我们对患者进行了一年的随访，并观察了即时和晚期并发症以及一年后的死亡率。为了减少偏倚，研究排除了病理性骨折、翻修手术、对侧骨折、高能量创伤、年龄小于60岁以及受伤侧先前有股骨近端骨折手术史的患者。
主要目的是研究MFI与一年死亡率之间的相关性。我们观察到MFI评分对一年时的死亡率有显著影响（p值 = 0.0316）。MFI评分每增加一个单位，死亡几率增加1.52倍。
MFI与老年髋部骨折手术后的一年死亡率和术后并发症之间存在很强的相关性。这种MFI可作为术前预测模型，用于预测老年髋部骨折后的死亡率和术后并发症。它还将有助于患者及其护理人员进行决策并阐明手术选择。
