O3039 WAYS OF REDUCING LETHALITY IN ELDERY AND SENILE PATIENTS WITH PROXIMAL FEMORAL FRACTURES

Abstract

Aims. The treatment of the proximal femoral fractures in the elderly people is connected with the presence of the marked somatic pathology, the forced supine position of the patients leading to hypostatic complications. According to the data of numerous studies one and only way to save such patient is to perform the early operative treatment. Methods. We made the analysis of treatment of 642 elderly and senile patients with the proximal femoral fractures, to which the unipolar or bipolar hip replacement was performed. The age of the patients was 51 to 96 years (average Ð 79,2). The operative procedures were performed as the urgent ones independently from the periods passed after the trauma. In connection with the periods of the operative procedure after trauma, all the injuried were divided into 5 groups: operated during the þrst day (219 patients), in 2–3 days (138 patients), in 4–6 days (89 patients), in 7–10 days (92 patients) and more than in 10 days (104 patients). As the principal criterion for the comparison we took the in-patient lethality. Results. The total lethality was 7,6% (49 patients). In the þrst group it was 4,1% (9 patients), in the second Ð 6,5% (9), in the third Ð 8,9% (8), in the fourth Ð 15,2% (14) and in the last Ð 8,7% (9). According to the performed analysis the lesser percentage of the lethal results was deþned in the case when the operative procedure was performed during the þrst day after trauma. Conclusions. Thus the main principle of the treatment of the patients with the mentioned pathology must be the early operative procedure performed during the þrst day after trauma. The late admission to the hospital is connected with the increasing of the operative risk, some part of the injuried die due to the underestimation of their status, insufþcient technical equipment of the specialized departments and some time due to the medical mistakes.