AGE AS A RISK FACTOR OF MORTALITY IN ELDERLY WITH A FRACTURE OF THE FEMORAL NECK
Abstract
Background. Age (life expectancy) determinates the method of treatment in patients with a fracture of the femoral neck. In retrospective study the autor asked: what is the mortality of patients after primary operation for a fracture of the femoral neck, are there differences in mortality among age groups and wheather age could be used to select the method of treatment in patients with a fracture of the femoral neck.
Methods and results. From 1984 to 1991 273 patients were operated for a fracture of the femoral neck. Two hundred and five were older than 64 years (»elderly«), and these were included in the study. Among them 24 were 65–69 years old, 85 were in seventies, 88 in eighties and eight in nineties. Fifty of 205 elderly patients died in six months (»early mortality« – 2.4%), 64 died in first year (31.2%) and 129 died in five years after injury (»late mortality« – 62.9%). Meanwhile, general one-year mortality of elderly was 6.6% for men and 5% for women. Early mortality for 65–69 age group was 16.6%, for 70–79 age group 22.3%, for 80–89 age group 26.1% and for > 90 age group 50%. Late mortality was 37.5%, 54.1%, 75% and 100% by age groups respectively. Stratified statistical analysis showed, that age influenced late mortality only, whereas all other risk factors (male gender, failed rehabilitation, nursery home status, associated cardiovascular disease, heart failure) influenced early as well as late mortality. To evaluate age independently of other risk factors, logistic regression analysis was done. Logistic regression analysis showed, that differences in early mortality among 65–69, 70–79 and 80–89 age groups were not significant and that difference in late mortality between 70–79 and 80–89 age group become significant not later than after five years, whereas at follow-up life expectancy for 70–79 age group was ten years for men and twelve for women, and for 80–89 age group five and six years respectively.
Conclusions. This retrospective study confirms that, »early mortality« of elderly patients with a fracture of the femoral neck is increased, and that differences in« late mortality« between age groups probably reflect different life expectancy. Age (life expectancy) is an important, but not the only factor in decision making, other risk factors should be considered primerely. With other words, physiological age is more important than chronological when selecting a method of treatment in an elderly patient with a fracture of the femoral neck.
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Statistični letopis 1995. Ljubljana: Statistični urad Republike Slovenije, 1995.
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