Retrospective analysis of clinical features and factors affecting mortality in geriatric patients diagnosed with proximal femur fracture in the emergency department

Aim: The aim of this study is to retrospectively analyze the clinical features and factors affecting mortality in geriatric patients diagnosed with proximal femur fracture in the emergency department. Materials and Methods: The study was initiated after obtaining approval from the Ethics Committee of Tekirdağ Namık Kemal University Faculty of Medicine (26.02.2024 approval date and 2024.44.03.08 number ). It is a retrospective descriptive study. Results: A total of 184 patients were included in the study, with 61% being female and 39% male. The average age of the patients was 81.15±7.66 years. Of the admissions, 42.4% occurred in 2023, 33.2% in 2022, and 24.5% in 2021. The highest number of admissions occurred in July and August, with the majority being in the summer months. The distribution of fracture sides was nearly equal (48.9% right, 51.1% left). The most common fracture type was intertrochanteric fractures at 47.3%, followed by femoral neck fractures at 44.6%. Subtrochanteric fractures accounted for 3.8%, isolated trochanteric fractures 3.3%, and femoral head fractures 1.1%. While 80.4% of patients received surgical intervention within 24 hours, 19.6% received it after 24 hours. The most commonly used medications in the emergency department were paracetamol, opioids, LMWH, and NSAIDs. The overall in-hospital mortality rate was 8.2%, and the 28-day in-hospital mortality rate was 7.1%. As the Charlson Comorbidity Index (CCI) score increased, so did the mortality risk. It was found that ICU admission, inotropic support, mechanical ventilation, and the need for intubation had significant effects on mortality. Conclusion: In conclusion, the main factors affecting mortality in geriatric patients with proximal femur fractures were determined to be gender, CCI, comorbidity burden, ICU and inotropic requirements, mechanical ventilation, and intubation.