European Journal of Molecular & Clinical Medicine

Abstract

Purpose: Proximal femoral fracture is one of the major causes of morbidity and mortality in
elderly group patientswith 11-23% of mortality is reported to occur at 6 months and 22-29%
at 1 year. Despite the huge burden of osteoporosis, there is paucity of data regarding
epidemiology, risk factors and outcome of fragility hip fractures in Indian population. As
most of the published literature are from western world, we conducted the study to look for
risk factors for early-mortality in hip fracture in Indian sub-continent and compare the same
with published literature.
Methods: Total of 174 patients were available for final evaluation. Primary outcome was to
see the mortality in elderly patients undergoing operative treatment and the secondary
outcome measures were predictors of mortality in this age group with regard to age, sex,
Charlson comorbidity index, injury severity score, pre-operative ASA grading, injury-surgery
duration and length of hospital stay. Cox proportional regression hazards regression
modelling was performed to assess the effect of different variables on time of mortality.
Results: Mean age of the patients was 70.56 (± 8.05) years. Mean Charlson Comorbidity
Score was 1.68 (± 1.54; 2SD). Mean time from injury to operation time was 35.59 (±19.02; 2
SD) hours and the mean length of hospital stay was 4.78 (± 1.68; 2 SD) days. Mortality at
one-year after surgery was 18.4%.On univariate and multivariate regression analysis variables
significantly associated (p<0.05) with ‘Mortality’ are: Age, Charlson Index, Charlson Index
Category, Injury to operation time(Hours), Length of hospital stay and pre-operative ASA
grade.
Conclusion: We suggest that, without a dedicated hip-fracture protocol in a resource-poor
set-up, early aggressive management to optimize patients for surgery and surgical
intervention as soon as feasible lead to early return to pre-fracture status and reduces early
mortality.