DEMOGRAPHIC AND LABORATORY PARAMETERS AFFECTING IN-HOSPITAL MORTALITY OF PATIENTS WITH PROXIMAL FEMORAL FRACTURES
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Abstract
Proximal femur fractures or hip fractures encompasses intertrochanteric fractures, fracture neck of femur and subtrochanteric fractures. The aim of the present study was to identify the demographic and laboratory parameters affecting mortality rates of in-hospital patients with proximal femoral fractures.
Materials and Methods: A retrospective study was conducted at Government Medical College, Thiruvananthapuram between 01/01/2018 to 31/12/2021. All consecutive patients above 20 years with neck of femur fractures, intertrochanteric fractures and subtrochanteric fractures, admitted in the hospital, were included in the study by searching the patient files.
Results: Total 607 patients were included in the study. Most of the patients belonged to age group 65 to 80 years (40.2%). There were 24 in-hospital deaths during the study period, the mortality rate being 3.95%. Mortality rate of age group 50-65 years was 2.17%, 65-80 years was 4.51, 80-95 years was 6.20 and that of above 95 years was 11.11% (p= 0.082). In urban patients, mortality rate was 0.79% and that of rural was 4.78% (p= 0.019). Ambulant patients had a mortality rate of 3.60% while that of non-ambulant patients was 12.5% (p=0.045). Patients with total count <4000 had a mortality rate of 100% and with >11000 rate of 3.68% (p=0.019). Patients with <1.5lakh platelet count had a mortality rate of 13.64% and that of >1.5 lakh was 3.2% (p=0.003). Creatinine level <1.4 mg/dL had a mortality rate of 3.61% and >3 mg/dL was 15.38% (p=0.015). Patients who had surgery within one day had no mortality and after 30days had a mortality of 14.29 (p=0.042).
Conclusion: In-hospital mortality of patients with proximal femoral fractures is the result of interaction of multiple factors. Rural patients and non-ambulant patients at admission had higher mortality rate. Patients with total count <4000, platelet count <1.5 lakh and creatinine >3 mg/dL had a higher mortality rate. Time between injury and surgery had an impact on mortality, higher mortality for delays more than 7 days.
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Shibu R
Department of Orthopaedics, Government Medical College, Thiruvananthapuram, India 695011
Jayachandran N
Department of Orthopaedics, Government Medical College, Thiruvananthapuram, India 695011
Ashok Ramakrishnan
Department of Orthopaedics, Government Medical College, Thiruvananthapuram, India 695011
Sarath S Kumar
Department of Orthopaedics, Government Medical College, Thiruvananthapuram, India 695011
Indhuprabha Yadev
Department of General Surgery, Government Medical College, Thiruvananthapuram, India 695011