FACTORS PREDICTING FIVE YEAR SURVIVAL IN PATIENTS WITH PROXIMAL FEMORAL FRACTURE

Abstract

The literature is filled with reports of various studies identifying perioperative factors that adversely affect survival. The aim of this study was to identify perioperative factors associated with an increased risk of death at 5 years.

All patients admitted to our unit in 2002 with a proximal femoral fracture were included. Demographic details, physiological parameters and biochemical parameters on admission were documented. Survival data at five years was available for all patients and was used to perform survival analyses. 633 patients with a proximal femoral fracture were admitted to our unit between January 2002 to December 2002. Data for all patients was available for analysis. There were 118 men and 515 women, M:F =1:1.4. Average age of the patients was 81.2±9.4 years (range 45–105 years).

Univariate analysis showed that patient age, mental test score, number of days delayed to surgery, number of comorbidities, ASA grade, if the patient lived in an institution, had a previous stroke, suffered from congestive cardiac failure or valvular heart disease, heart rate, serum haemoglobin, serum urea and whether the patient developed a post operative complication were all significant factors that affected survival. Multivariate analysis showed that mental test score (Exp B=0.939 95%CI=0.901–0.978 p= 0.002), age (Exp B = 1.031 95%CI= 1.004–1.058 p= 0.025) and ASA grade (Exp B = 1.458 95%CI= 1.039–2.046 p= 0.029) were all independent variables that affected five year survival.

Various independent factors affect five year survival in patients with proximal femoral fracture. It is important that these factors are identified firstly, so that patients and relatives can be given information about survival and secondly, so that high risk patient groups can be allocated adequate resources in order that their peri and postoperative care is optimised. This may improve outcome in these subgroups of patients.