Analysis of one-year postoperative mortality and risk factors of elderly patients with intertrochanteric fractures after PFNA

Abstract

Background: Intertrochanteric fracture is very common in elderly patients, It is one of the main reasons for the elderly to be hospitalized, and is closely related to the mortality rate. With the speeding up of the population aging, the treatment of intertrochanteric fracture is becoming more and more significant. PFNA (Proximal femoral nail antirotation) is the most commonly used surgical method, although the surgical technique has improved a lot, the postoperative mortality rate after one year is still high. If we can take active and effective control measures against the high-risk factors affecting mortality in time, it will help to improve the prognosis. Aim: To study the 1-year postoperative mortality rate of elderly patients with intertrochanteric fractures after being treated with proximal femoral nail antirotation (PFNA) and its influencing factors. Patients and Methods: The data of patients with intertrochanteric fracture treated by PFNA in our hospital during the period from August 2016 to April 2020 were retrospectively studied, and the data of age, sex, type of fracture, preoperative comorbid diseases, American Society of Anesthesiology (ASA) score, the timing of the operation, duration of operation, preoperative and postoperative hemoglobin levels, albumin level, and postoperative complications were collected through medical records, and the survival rate of patients in 1 year after operation was investigated by telephone follow-up, and single-factor analysis was carried out to analyze related influencing factors. Results: A total of 80 patients with complete data were followed up for 1–23 months (mean 12.5 months), and totally 22 patients died within 1 year, the mortality rate was 27.5%. Single analysis results suggested that the differences in factors such as age, number of preoperative combined diseases, ASA score, preoperative and postoperative albumin levels, and postoperative complications between the survival group and the death group were statistically significant (P < 0.05). Conclusion: The risk factors affecting long-term death in the treatment of intertrochanteric fractures in elderly patients with PFNA shall be taken into consideration fully, and the improvement of preoperative and postoperative health status will help to reduce the postoperative mortality and improve the efficacy of surgery.