Incidence and Risk Factors of Mortality in Nonagenarians and Centenarians After Intertrochanteric Fracture: 2-Year Follow-Up

Abstract

Purpose

The purpose of this study was to explore risk factors for mortality after intertrochanteric fracture (IF) surgery in nonagenarians and centenarians based on subgroups of follow-up time.

Patients and Methods

A total of 144 nonagenarians and centenarians who underwent IF surgery between Jan. 2014 and Dec. 2018 were included. Data were compared between the mortality and the survival groups based on the subgroups of follow-up time in univariate, logistic regression, and Cox regression analyses.

Results

In our study, the rates of mortality were 7.6%, 13.9%, and 28.5% at 6-month, 1-year, and 2-year follow-up, respectively. Univariate analysis showed that prolonged time from injury to surgery, more transfusion volume, lower hemoglobin (minimum), and complications (respiratory failure and anemia) were associated with mortality at 6-month follow-up. However, three factors were found to be related to mortality at 1-year and 2-year follow-up, respectively. Our results showed that postoperative respiratory failure and anemia were independent risk factors for mortality after IF surgery at 6-month in logistic regression analysis. However, postoperative respiratory failure was found as an independent risk factor for mortality at 1-year and 2-year follow-up. Moreover, Cox regression analysis showed that postoperative respiratory failure was an independent risk factor for mortality after IF surgery, which was consistent with results in logistic regression analysis.

Conclusion

Postoperative respiratory failure was an independent risk factor for mortality in nonagenarians and centenarians at any follow-up. Additionally, postoperative anemia was closely related to mortality. Preoperative measures should be taken to lower mortality.

Keywords:

• nonagenarians and centenarians
• mortality
• intertrochanteric fracture
• risk factors

Abbreviations

IF, intertrochanteric fracture; BMI, body mass index; ASA, American Society of Anesthesiologists.

Data Sharing Statement

The dataset generated and/or analyzed during the current study is not publicly available due to patient-related confidentiality, but it is available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

This study was approved by the institutional review board of the third Hospital of Hebei Medical University (K2020-032-1) in compliance with the Declaration of Helsinki and consent was waived for this non-interventional, observational, and retrospective study, in which the patient data used were kept strictly confidential.

Disclosure

The authors declare that there is no conflict of interest regarding the publication of this paper.

Additional information

Funding

The study was financially supported by the National Key R&D Program of China (No. 2019YFC0120600), the 2019 Hebei Provincial Department of Finance Geriatric Disease Prevention and Control Funds, and Baoding City Science and Technology and Intellectual Property Bureau (No. 2041ZF260).