One Year Mortality in Elderly Patients with Fracture Proximal Femur Managed Surgically in District Headquarter Hospital Rawalpindi

Objective: To determine one year mortality rate in elderly patients who were operated for fracture proximal femur in District Headquarter Hospital Rawalpindi. Methods: This descriptive study was conducted in Orthopaedic Department District Headquarter Hospital Rawalpindi from 3rd January 2017 to 25th December 2019. All patients with proximal femur fracture (neck of femur, per trochanteric and sub trochanteric fractures) fulfilling the inclusion criteria and who were operated were included in our study. Post operatively all these patients were followed up at regular intervals up to one year to document mortality. Chi square test for independence was used to calculate P values of important variables and P value of <0.05 was considered statistically significant. Results: A total of 161 patients with mean age was 71.1± 10.0 years were included in our study. There were 90(55.9%) males and 71(44%) females. Majority(62.1%,n=100) of fractures were pertrochanteric followed by neck of femur(34.8%,n=56) and subtrochanteric fractures(3.1%,n=5).Dynamic Hip screw(DHS) was used to fix fractures in 105(65.2%),Austion Moore Prosthesis(AMP)in 31(19.3%),Total Hip Replacement(THR) in 17(10.6%) and Dynamic Condylar Screw(DCS) in 3(1.9%) patients. At one year the overall mortality rate was 20.5% (n=33). Patients of 80 years and above had significantly higher mortality (34.8%, n=15) rate than others (P= 0.006337).The mortality was also significantly greater in females (28.2%,n=20) than male patients (14.4%,n=13) with P value of 0.032201. Patients operated for neck of femur fractures had significantly higher mortality rate (30.4%, n=17) than those operated for pertrochanteric fractures (16%, n=16) with P value of 0 .02361. Conclusion: Elderly female patients age 80 years and above operated for neck of femur fractures exhibited a higher mortality rate at one year follow up than others.