title: Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.
abstract: BACKGROUND
  Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes.
  
  
  METHODS
  We included 785 patients age 65 years or older, with hip fractures. Operative treatment consisted of external fixation, internal fixation, total hip arthroplasty and hip hemiarthroplasty. Age, gender, type of fracture, type of surgery performed, American Society of Anesthesiology (ASA) grade, clinical comorbidities, anesthesia type, blood transfusion requirement, time to surgery, intensive care unit requirement, operation length and length of hospital stay and number of comorbidities were documented.
  
  
  RESULTS
  During the study period, 785 patients (262 male, 523 female) were included to study, Overall mortality rate was 37.2 % (292/785). Their age ranged between 65 and 100 years (mean 81). Surgery type Kaplan-Meier cumulative mortality curves suggested no significant difference between four different types of surgery groups (p = 0.064). Transfusion requirement was significantly lower in external fixation group comparing to other groups (p = 0.014). Cox regression analysis showed the number of comorbidities 2 and ≥ 3 (p = 0.0027, p = 0.015), transfusion requirement (p = 0.0001), ASA 4 (p = 0.016) to be significant predictors of mortality.
  
  
  CONCLUSIONS
  Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey. ersine@hotmail.com.
authors: Ersin
authors: E
authors: Ercin
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey.
authors: M Gokhan
authors: MG
authors: Bilgili
authors: Department of Orthopaedics and Traumatology, Luleburgaz Training and Research Hospital, Kirklareli, Turkey.
authors: Cihangir
authors: C
authors: Sari
authors: Department of Orthopaedics and Traumatology, Karabuk University, Karabuk, Turkey.
authors: S Hakan
authors: SH
authors: Basaran
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey.
authors: Bulent
authors: B
authors: Tanriverdi
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey.
authors: Erdem
authors: E
authors: Edipoglu
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey.
authors: K Mumtaz
authors: KM
authors: Celen
authors: Department of Algology, Medical Faculty of Istanbul, Istanbul University, Istanbul, Turkey.
authors: Halil
authors: H
authors: Cetingok
authors: Department of Orthopaedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam cad. No: 11, Zuhuratbaba, 34147, Istanbul, Turkey.
authors: Cemal
authors: C
authors: Kural
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality*; D001803:Blood Transfusion / Q000401:mortality; D005260:Female; D005592:Fracture Fixation / Q000401:mortality*; D005593:Fracture Fixation, Internal / Q000401:mortality; D062785:Hemiarthroplasty / Q000401:mortality*; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors
keywords: External fixator; Hip fracture; Mortality risk; Survival