Citation

Schultz KA, Westcott BA, Barber KR, Sandrock TA. Geriatr Orthop Surg Rehabil 2020; 11: e2151459319898644.

Affiliation

Greater Michigan Orthopedics, Grand Blanc, MI, USA.

Copyright

(Copyright © 2020, SAGE Publishing)

DOI

10.1177/2151459319898644

PMID

32010476

PMCID

PMC6971960

Abstract

INTRODUCTION: Low-energy proximal femur fractures are common in the aging population and the ability to identify patients at increased mortality risk provides surgeons information to improve informed decision-making with patients and families. We evaluated for gender differences in 1-year mortality after sustaining low-energy proximal femur fractures with subgroup analysis to identify the impact of fracture location, age, and comorbidities on mortality.

MATERIALS AND METHODS: Patients ≥40 years of age sustaining a low-energy proximal femur fracture identified at our institution between January 1, 2014, and December 31, 2017. International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes were used to identify comorbidities for calculation of the age-adjusted Charlson comorbidity index (ACCI). The county clerk database was searched to identify mortality within 1 year of injury. One-year mortality rates were calculated and multiple comparisons were made between genders controlling for age, fracture location, and/or ACCI.

RESULTS: Women presented with low-energy proximal femur fractures at a rate of almost 3:1 to men at our institution (P =.001). Men demonstrated a significantly increased ACCI at presentation (5.35 ± 2.55 vs 4.86 ± 1.77, P =.03). Men had an increased 1-year mortality rate for all (31.3% vs 21.5%, P =.004) and intertrochanteric (IT) fractures (36.2% vs 22.9%, P =.008). Controlling for ACCI, gender, and fracture location, men demonstrated increased mortality rate with IT fractures (P =.002) and trended toward but did not reach significance with femoral neck fractures (P =.07).

DISCUSSION: Men presenting with low-energy femur fractures are at an increased mortality risk compared to women. On average, men present with an overall worse health status as identified by ACCI, which could predispose these patients not only to fractures themselves but also impair their ability to recover from injury.

CONCLUSION: Men are at an increased 1-year mortality risk after sustaining proximal femur fractures.

© The Author(s) 2020.

Language: en

Keywords

age-adjusted Charlson comorbidity index; fragility fractures; geriatric trauma; hip fracture mortality; osteoporosis; proximal femur fractures