title: [Proximal femur fractures in elderly patients: the influence of comorbidity on prognosis in the short, medium and long term].
abstract: BACKGROUND
  Our study aims to assess post-intervention and pre-operative mortality in patients admitted to our institute diagnosed with a fractured proximal femur. The influence of comorbidity on prognosis in the short (1 month), medium (3 month) and long term (6 month) was assessed between July 2006 and July 2009.
  
  
  METHODS
  The 238 patients (85 men and 153 women), between 65- and 99-year-old, were followed-up as outpatients and by telephone for 1 year to monitor the state of persistence in life or eventually the date of death. The comorbidity parameters considered were: sex, age, ASA class of anesthetic risk, fracture location and type of surgical treatment used, the number of previous associated diseases and the presence/absence of cognitive impairment on admission.
  
  
  RESULTS
  The data obtained, in comparison with that of the general population in the Lazio region (ISTAT table), showed. Higher mortality rate in men than women, high mortality rate for patients with cognitive impairment at admission (50%), mortality over twice as high in patients belonging to ASA classes III and IV than in patients belonging to the lower categories. By observing the time between surgery and death it was also evident that the first 6-month period was the most critical; furthermore, 45.45% of deaths occurred within the first 60 days.
  
  
  CONCLUSIONS
  Identifying the causes that influence the mortality of our patients and being able to quantify the relevance in subsequent death enables us to improve the care for the risk, strengthen the therapeutic choices based on new evidence, and especially lay the groundwork for the development of new treatment protocols, useful for clinical and forensing decision-making.
authors.affiliation: Ortopedia e Traumatologia B, Università Sapienza, Roma, Italia. digiorgioluigi@siot.it
authors.forename: L
authors.initials: L
authors.lastname: Di Giorgio
authors.forename: L
authors.initials: L
authors.lastname: Sodano
authors.forename: G
authors.initials: G
authors.lastname: Touloupakis
authors.forename: P
authors.initials: P
authors.lastname: Piciocco
authors.forename: D
authors.initials: D
authors.lastname: Attala
authors.forename: C
authors.initials: C
authors.lastname: Villani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000401:mortality*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors