Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old

Chul Hong Kim; Kyu Yeol Lee; Sung Soo Kim; Myung Jin Lee; Lih Wang; Hyeon Jun Kim; Jung Mo Kang

doi:10.5371/hp.2013.25.2.127

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Kim, Lee, Kim, Lee, Wang, Kim, and Kang: Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old

Original Article

Hip & Pelvis 2013; 25(2): 127-134.

Published online: 30 June 2013

DOI: https://doi.org/10.5371/hp.2013.25.2.127

Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old

Chul Hong Kim, MD, Kyu Yeol Lee, MD, Sung Soo Kim, MD, Myung Jin Lee, MD, Lih Wang, MD, Hyeon Jun Kim, MD, Jung Mo Kang, MD

Department of Orthopedic Surgery, School of Medicine, Dong-A University, Busan, Korea.

Address reprint request to Hyeon Jun Kim, MD. Department of Orthopedic Surgery, School of Medicine, Dong-A University, Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. TEL: +82-51-240-2757, FAX: +82-51-254-6757, hyeonjun@dau.ac.kr

Received 20 April 2013 Revised 20 June 2013 Accepted 21 June 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study examined therelationship between the clinical outcome and risk factors of intertrochanteric femoral fractures in patients over 65 years old.

Materials and Methods

From January 2000 to March 2012, three hundred and twenty one patients older than 65 years, who underwent surgeryfor intertrochanteric femoral fractures, were evaluated. The following parameters wereanalyzed: the patient risk factors, such as age, sex, smoking, drinking history, cardiovascular disease, cerebrovascular disease and delayed days to surgery; admission day of the week; anesthetic method; operation time by perioperative care related to clinical outcome including postoperative mortality; and complications.

Results

An analysis of the risk factors revealedfemale patients to have a 13% higher mortality (P=0.043). Aduration of surgerylonger than 3 hours was associated with a 29.1% and 20.8% higher mortality and complication rate, respectively (P<0.001, P=0.027). Asurgical delay of four days or more after admission wasassociated with a 20.1% and 18.8% higher mortality risk and complication rate, respectively (P<0.001, P<0.001). Smoking, drinking history, underlying disease, anesthetic method, and operation time had no significant effect on the outcome.

Conclusion

In addition to recognizing the importance of patient-related risk factors, modifying the operative factors, such as reducing surgical delays and method of anesthesia, can reduce the mortality and postoperative complications of intertrochanteric femoral fractures.

Keywords: Intertrochanteric fracture, Mortality

Figures and Tables

Table 1

Analysis of Patient Characteristic Factors on Mortality and Complications

Table 2

Analysis of Underlying Disease Factors on Mortality and Complications

Table 3

Analysis of Surgery and Anesthesia Related Factors on Mortality and Complications

Table 4

Analysis of Hospital Related Factors on Mortality and Complications

Table 5

Logistic Regression Analysis of Various Factors on Mortality and Complication

^*OR: odds ratio.

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