Hip fracture among elderly people: a single cohort study from Kurdistan of Iraq

Abstract

Background: Hip fracture is considered a major health problem worldwide. The current study aimed to investigate hip fracture characteristics among older people in Iraq and factors involving postoperative mortality.Method: A single cohort study was carried out in Sulaimani and Shar Teaching hospitals in Sulaimani from the 1st of July 2018 to 30th of June 2019. Hip fracture was diagnosed by a specialist physician using an X-Ray. The data was collected by the researcher through direct interviews and filling a prepared uniform questionnaire. The data analyzed by SPSS and p-value<0.05 was significant.Results: From the total of 100 hip fracture patients included, the average age of patients was 74.45±8.18 years. Fifty-nine patients aged 60 to 75 years, while the rest were older than 75 years. Female consisted of 59.0% of the total samples. Non-mechanical falls accounted for (84%) of all falls. Most patients had intertrochanteric fractures (65%), while 35% had femoral neck fractures. The Proximal femoral nail (PFN) operation was the primary type of operation (77%) performed. Most patients (94%) were discharged after two days. There was a significant association between gender and postoperative mortality; female patients had worse prognosis and higher mortality, relative risk (95%CI) 0.18 (0.0424 to 0.7788). Older patients aged 75 and more had a remarkably poorer prognosis than younger patients, relative risk (95%CI) 0.30 (0.10 to 0.93). There was a strong relationship between poor cognitive function (moderate to severe depression) and postoperative mortality rate with relative risk (95%CI) 0.04 (0.006 to 0.36). Finally, patients on three or more medications also had an outstanding worse prognosis, relative risk (95%CI) 0.022 (0.001 to 0.37). Conclusion: Hip fracture was more common among women and people aged above 75 years. The prevalence of intertrochanteric fractures was nearly double the femoral neck fractures. Age, female, depression, and polypharmacy had a statistically significant association with three-month mortality in hip fracture patients.