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Surgical treatment of hip fractures in patients aged 90 years old and over: Multifactorial retrospective study

Yucel Bilgin, Fevzi Birisik.




Abstract

Hip fractures are an important cause of morbidity and mortality in the geriatric age group. Life expectancy is increasing day by day. In this study, we aimed to review the hip fracture patients aged 90 years and over in terms of treatment process, mortality rates and mortality risk factors as a separate group. Patients aged 90 years and over, who presented to our clinic within 24 hours after fracture, who underwent surgery with the diagnosis of proximal femur fracture (intertrochanteric or collum femoris fracture) and who had a postoperative follow-up for at least 1 year were included in the study. There were 62 patients (21male, 41female) who included the criteria for participation in the study. The average age of all patients was 92,9±2,94 (90-104) years. The fracture type of 29 (46.77%) patients was intertrochanteric femur fracture. Osteosynthesis was performed with a proximal femur nail in the surgery of these patients. The fracture type of 33 (53.23%) patients was collum femoris fracture. Bipolar cementless hemiartroplasty was performed in the surgery of these patients. The mortality rate in the first month after surgery was 20.97%. The mortality rate in the first year after surgery was 40.32%. High Charlson Comorbidity Index (CCI: 3 and above) (p = 0.01), high ASA score (ASA: 3-4) (p = 0.04), length of hospital stay (p = 0.03), need for intensive care follow-up (p = 0.02) and the number of days in intensive care (p = 0.03) were found to be associated with a high mortality rate.

Key words: Hip fracture, mortality, morbidity, risk factors






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