Analysis of factors among 30-day and 1-year mortality rates in patients with borderline stable-unstable intertrochanteric hip fracture

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dc.contributor.authorCanbeyli, Ibrahim Deniz
dc.contributor.authorÇırpar, Meriç
dc.contributor.authorOktaş, Birhan
dc.contributor.authorÇoban, Mehmet
dc.date.accessioned2025-01-21T16:34:19Z
dc.date.available2025-01-21T16:34:19Z
dc.date.issued2021
dc.departmentKırıkkale Üniversitesi
dc.description.abstractObjective: This study aimed to evaluate the possible effects of surgical procedures on mortality and to identify the possible risk factors for mortality in the management of geriatric hip fractures. Methods: A total of 191 patients (105 women and 86 men: mean age 82.26 +/- 9.681 [60-108] years) with AO/OTA 31A2.2 intertrochanteric fractures and treated with sliding hip screw, proximal femoral nail, or hemiarthroplasty were included in this retrospective cohort study. The treatment type was decided by the responsible surgeon according to the patients' pre-injury activity level, bone quality, and features of the fracture. Age, sex, type of fracture. type of surgery performed, American society of anesthesiology (ASA) grade, type of anesthesia, time to surgery, type of physical therapy, length of hospital stay, and number of comorbidities were documented. We evaluated the 30-day and 1-year mortality of patients treated with sliding hip screw (SHS), proximal femoral nail antirotation (PFN-A), or hemiarthroplasty and identified the possible risk factors for mortality. Results: A total of 49 patients underwent SHS, 58 underwent PFN-A, and 84 underwent hemiarthroplasty. Of these, 2 patients with SHS, 2 with PFN-A, and 11 with hemiarthroplasty died within 30 days after surgery, whereas 7 patients with SHS, 15 with PFN-A, and 23 with hemiarthroplasty died 1 year after surgery. The 30-day and 1-year overall mortality rates were 7.9% and 23.6%, respectively. Both the 30-day and 1-year mortality risks were higher in patients undergoing hemiarthroplasty than in patients undergoing SHS (p=0.068 versus 0.058). The 30-day mortality was higher in patients receiving general anesthesia than in those receiving combined spinal and epidural anesthesia (p=0.009). The 1-year mortality risk was higher in patients with ASA grade 4 than in those with grade 1 and 2 (p=0.045). Advanced age (p=0.022) and male sex (p=0.007) were also found to be the risk factors for 1-year mortality. Conclusion: We demonstrated that higher ASA grade, male sex, general anesthesia, and hemiarthroplasty procedures are associated with higher mortality rates in elderly patients with hip fractures. Thus, we highly recommend orthopedic surgeons to consider all these factors in the management of intertrochanteric hip fractures in the geriatric population.
dc.identifier.doi10.5152/j.aott.2021.20071
dc.identifier.endpage21
dc.identifier.issn1017-995X
dc.identifier.issue1
dc.identifier.pmid33650505
dc.identifier.scopus2-s2.0-85102074185
dc.identifier.scopusqualityQ2
dc.identifier.startpage16
dc.identifier.trdizinid446723
dc.identifier.urihttps://doi.org/10.5152/j.aott.2021.20071
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay446723
dc.identifier.urihttps://hdl.handle.net/20.500.12587/23944
dc.identifier.volume55
dc.identifier.wosWOS:000625311400006
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakTR-Dizin
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherTurkish Assoc Orthopaedics Traumatology
dc.relation.ispartofActa Orthopaedica Et Traumatologica Turcica
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_20241229
dc.subject30-day mortality; 1-year mortality; Geriatric hip fractures; Sliding hip screw; Intramedullary nailing; Hemiarthroplasty
dc.titleAnalysis of factors among 30-day and 1-year mortality rates in patients with borderline stable-unstable intertrochanteric hip fracture
dc.typeArticle

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