MORTALITY AND LIFE EXPECTANCY OF ELDERLY PATIENTS WITH PROXIMAL FEMORAL FRACTURE - A 2.5 YEARS FOLLOW-UP IN 78 PATIENTS OVER 75 YEAR-OLD

Purpose of the study The purpose of this study was to highlight factor s influencing vital and functional prognosis at. 2.5 years of elderly people being treated for a proximal femoral fracture. Material The stu dy was based on 78 patients more than 75 years old admitted to the ort hopedic department for emergency treatment. After post-operative care, patients were transferred to a geriatric readaptation unit. The avera ge patient age at the time of surgery was 85 years. Methods This was a retrospective study. Survival graphs were established for the entire population as well as for the sub-populations characterized by a studi ed parameter. Mortality factors were compared via a univariable analys is. A multivariable logistical regression analysis isolated the factor s explaining mortality at 12, 18, and 30 months and survival at 30 mon ths, as well as factors explaining functional prognosis at 1 year. Res ults The overall mortality rate was 41 per cent, 48.5 per Gent of deat hs occur within the first year. Factors which are harmful for vital pr ognosis are tile following : high degree of dependence before the frac ture, the existence of a neuropsychiatric pathology, and age factor (m ore than 85 years). 61.5 per cent of surviving patients were independe nt for daily activities. 77 per cent of surviving patients lived in th eir usual place of residence. Factors which were harmful for functiona l prognosis were the following : type of the fall, symptomatic of an u nderlying pathological stale, and existence of a neuropsychiatric path ology. Nutrition was also a predictive factor concerning the patient's out come. Discussion The average age of the studied population was hi gher than in most studies in literature, The treatment is mainly based on hip arthroplasty. The group of patients of over 85 have the highes t mortality rate, However, a better survival rate at 18 months has bee n observed for patients older than 90 years, The delay before surgical care was significantly negative if longer than 6 days, However, a del ay of 3 to 6 days was not significantly harmful for survival. Within t he studied population, the maximum autonomy gain was observed during t he first 6 months. The type of nan-accidental fall, symptomatic of an associated pathology, was a factor for functional prognosis which has not been often mentioned. So was the biological deficit of nutrition. Social status acted as an indicator of functional status evolution. Co nclusion Therapeutic choices can only be guided by assessments of pati ents' vital and functional prognosis. A sophisticated or even expensiv e device should be demanded for patients with favorable prognosis. For patients with precarious functional and vital prognosis, priority sho uld be given to less Invasive techniques with immediate walking, The c ost of the device should be correlated with patient's functional inves tment.