title: Hip fractures in patients older than 75 years old: Retrospective analysis for prognostic factors.
abstract: BACKGROUND
  Proximal femoral fractures are often seen in older patients and are associated with high mortality. Introduction to old age population is latening due to advancements in medical sciences and increasing life expectancy.
  
  
  OBJECTIVE
  The aim of the study was to evaluate factors affecting mortality in patients above 75 years of age who had been operated because of proximal femur fractures.
  
  
  METHODS
  Patients with age 75 and over who suffers from post-fall proximal femoral fracture who underwent surgery with one of following three methods (hemiarthroplasty, proximal femoral nail or total hip arthroplasty) were evaluated retrospectively. Effects on mortality were examined for factors such as type of surgery, type of anesthesia, preoperative ASA score (American Society of Anesthesiologists Score), need for intensive care, need for blood transfusion, operation waiting time and hospitalization duration. 115 patients who met inclusion criterion were included in the study out of 224 overall. 75 patients were women and 40 were males.
  
  
  RESULTS
  Mortality rate after first year was found to be 40%. Patients over 85 years old had higher rates of mortality (p = 0,0003) than respectively younger patients (75-85). Sex was found to have no impact on mortality (p = 0.5039). There was no statistically significant difference in terms ASA score (p = 0.1518). Order of applied surgical methods with mortality risk rates was found to be total hip arthroplasty > hemiarthroplasty > proximal femoral nail (p = 0.0003). Type of anesthesia, the use of cement during arthroplasty, operation waiting time and hospitalization duration was not directly related with mortality rate (type of anesthesia p = 0.63, the use of cement during arthroplasty p = 0.223, operation waiting time p = 0.5 and hospitalization duration p = 0.19).
  
  
  CONCLUSIONS
  Age is the primary risk factor on first year mortality in patients older than 75 years old with hip fractures. Addition to older age, more need to blood transfusions, and arthroplasty are other risk factors for first year mortality. It should be kept in mind that after 75 years old first year mortality may be higher if the patient is treated with arthroplasty.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: dr@gokhankarademir.com.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Karademir
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: yucelbilgin70@hotmail.com.
authors.forename: Yücel
authors.initials: Y
authors.lastname: Bilgin
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: ali_ersen@hotmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Erşen
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: gokhanpolat7@gmail.com.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Polat
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: mbuget@yahoo.com.
authors.forename: Mehmet I
authors.initials: MI
authors.lastname: Buget
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: dr88.mehmet.demirel@gmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Demirel
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Çapa Fatih, Istanbul, 34050, Turkey. Electronic address: balcihalili@gmail.com.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Balcı
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014421:Turkey / Q000453:epidemiology
keywords: Affecting; Factors; Hip fracture; Mortality; Over 75 years of age; Prognostic; Proximal femoral fracture