Retrospective review of geriatric patients diagnosed with proximal femur fracture

Ojective: The aim of this study is to retrospectively examine geriatric patients diagnosed with proximal femur fracture who come to the emergency department and to reveal the factors affecting mortality. Material and method: Our study is based on demographic data, vital signs, laboratory findings, POSSUM physiological parameter score, CCI and ASI scores, ICU admission or not, of patients aged 65 and over who were admitted to our emergency department between 01.01.2019 and 31.12.2020, diagnosed with proximal femur fracture. and survival at 1 and 3 months were examined. The data were obtained from the electronic records and archived patient files of Muğla Training and Research Hospital. Multiple trauma patients, patients under 65 years of age, patients whose files could not be reached, and patients who refused treatment were excluded from the study. Results: A total of 305 patients, 63.3% (193) of whom were women, were included in our study. The mean age of all patients was calculated as 81.81±7.38 years. The most common fracture type was intertrochanteric (66.9%) and the least trochanter major (0.7%) fracture type. When the cases were examined as outcome, it was observed that 19% of the patients were hospitalized in the ICU, 7.9% of the patients died in the first month, and 14.1% of the patients died in the 3 months. Advanced age, Glasgow coma scale (GCS), oxygen saturation, POSSUM physiological score, CCI and ASI scores in ICU admissions; advanced age, GCS, POSSUM physiological score and hematocrit in the 1st month mortality estimation; heart rate per minute, POSSUM physiological score and ASI score were found to be statistically significant in the estimation of mortality at 3 months. An ASI score above 51.59 has a sensitivity of 75% and 62.8%, and a specificity of 66.5% and 67.6%, respectively, in predicting 1st and 3rd month mortality. The POSSUM physiological score, on the other hand, has a sensitivity of 66.7% and 62.2%, and a specificity of 59.8% and 61.1%, respectively, in predicting 1st and 3rd month mortality over 21.5%. Conclusion: We think that it would be appropriate for emergency medicine specialists to consider that patients with a POSSUM physiological score above 21.5 and/or with an ASI score above 51.59 may be mortal when evaluating patients with proximal femur fracture in the emergency department and plan patient management accordingly.