Keshav Kumar, Singh Siddhartha, Sharma Pulak, Baghel Anurag, Kumar Amit, Mishra Prabhaker
Department of Orthopaedics, Apex Trauma Centre, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Vrindavan Yojna, Raebareli Road, Lucknow, U.P., PIN-226029, India.
Department of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, U.P., PIN-226014, India.
J Clin Orthop Trauma. 2025 May 13;67:103058. doi: 10.1016/j.jcot.2025.103058. eCollection 2025 Aug.
We conducted a retrospective study of prospectively collected data to find the thirty-day and one-year mortality rate among geriatric patients with surgically operated hip fractures, and to evaluate the possible association with various non-modifiable and modifiable factors amongst deceased and survivors.
All elderly patients (above 60 years) with hip fractures (trochanteric or/and femoral neck) admitted and operated between July 2018 to February 2024 and having a minimum follow-up of 4.5 months (18 weeks) if alive, were included. Patients that were managed non-operatively, age <60 years, having associated lower limb injuries or polytrauma, those not falling within the time duration mentioned above and previously operated cases of hip fractures were excluded from the study. Telephonic enquiries were done to patients or their relatives to know whether the patients were alive or had expired. The data, so collected, was used to find the mortality rate. Relevant statistical analyses were applied to look for any association between the mortality and various data-demographic, injury-related, comorbidities and hematological.
A total of 168 patients were included based on inclusion-exclusion criteria. Out of these, there were 136 patients having a follow-up of one year or more. 30-day mortality in our series was 4.76 % (8 out of 168) and 1-year mortality was 19.85 % (27 out of 136). Presence of "any comorbidity" and "the total number of comorbidities" at admission had a significant association with deceased individuals in comparison to non-deceased ones (p-value<0.001 in both). There was also a statistically significant negative association of the survival time (number of days) with the number of comorbidities.
Mortality rate following hip fractures in geriatric patients remains as high as one-fifth at one year. Comorbidities have a significant effect on one-year mortality and the postoperative survival duration is negatively associated with number of comorbidities.
我们对前瞻性收集的数据进行了一项回顾性研究，以确定接受手术治疗的老年髋部骨折患者的30天和1年死亡率，并评估死亡患者和存活患者中各种不可改变和可改变因素之间的可能关联。
纳入2018年7月至2024年2月期间收治并接受手术的所有髋部骨折（转子间或/和股骨颈）老年患者（60岁以上），若患者存活，其最短随访时间为4.5个月（18周）。非手术治疗的患者、年龄<60岁、伴有下肢损伤或多发伤的患者、不在上述时间段内的患者以及既往有髋部骨折手术史的患者被排除在研究之外。通过电话询问患者或其亲属，了解患者是否存活或已死亡。收集到的数据用于计算死亡率。应用相关统计分析方法，寻找死亡率与各种数据（人口统计学、损伤相关、合并症和血液学）之间的任何关联。
根据纳入排除标准，共纳入168例患者。其中，136例患者的随访时间为1年或更长。我们系列中的30天死亡率为4.76%（168例中的8例），1年死亡率为19.85%（136例中的27例）。与未死亡个体相比，入院时“任何合并症”的存在和“合并症总数”与死亡个体有显著关联（两者p值均<0.001）。生存时间（天数）与合并症数量之间也存在统计学上显著的负相关。
老年患者髋部骨折后的死亡率在1年时仍高达五分之一。合并症对1年死亡率有显著影响，术后生存时间与合并症数量呈负相关。
