Factores de riesgo para el ingreso prolongado y mortalidad intrahospitalaria en la fractura del fémur proximal en pacientes mayores de 65 años

Abstract

PurposeTo determine the risk factors influencing in-hospital mortality and/or increased hospital stay in patients older than 65 years with proximal femur fracture. MethodsRetrospective study of patients aged over 65 years operated on for hip fracture between January 2015 and December 2017. Medical, psychological, functional and analytical comorbidities present at admission as well as treatment, complications and analytical follow-up during admission and functional status and residence at discharge are studied for a total of 54 variables. A bivariate analysis was performed using a composite endpoint between in-hospital mortality and the increase of more than 10 days of hospital stay. Results360 patients were included with a mean age of 84 years. 75% were women and 53.5% suffered a pertrochanteric fracture. The mean number of comorbidities per patient was 2.7 (0-7), the most frequent being hypertension, dementia and diabetes. In-hospital mortality was 3.6% (n: 13) and mean hospital stay was 8.4 days (1-35), with 16.4% exceeding 10 days. The presence of medical complications (p<0.001), hemoglobin level at admission (p<0.001), arterial hypertension (p=0.012), obesity (p=0.018) and parkinson (p=0.034) were related to the occurrence of the studied cut-off point. ConclusionArterial hypertension, obesity, Parkinson's disease, hemoglobin level at admission and occurrence of medical complications are variables that increased the risk of in-hospital mortality and/or a hospital stay above 10 days in patients older than 65 years with proximal femoral fracture.