Outcomes in fracture neck of femur patients in an Indian setting

Abstract

Background: To determine the morbidity and mortality outcomes in patients presenting with a fracture neck of femur in an Indian setting. Unfavourable outcomes were identified in Peri-operative period and planning to improve the peri-operative care was taken. Methods: We performed a retrospective observational study of 230 consecutive adult patients admitted to an Indian metropolitan tertiary care hospital with fracture neck of femur between 2010 and 2012. The main outcome measure were 30 days and one year mortality rates, major complications and factors influencing mortality. Results: The majority of patients were elderly, female and had multiple comorbidities. Multiple peri-operative medical complications were including pre-operative hyponatremia (21%), post-operative hypoxia (14%), anaemia requiring blood transfusion (36%), re-admission with in 30 days of discharge (12%), acute renal complications (8%), and myocardial infraction (4%) Mortality rates were 5% at 30 days and 12.5% at one year. Conclusion: Results from an Indian metropolitan tertiary care hospital confirm the persistently high morbidity and mortality in patients presenting with a fractured neck of femur. Efforts should be aimed at medically optimising patients pre-operatively and early surgery. This study provides planning data for future interventional studies.