Mortality and Prognostic Factors in Intertrochanteric Femur Fractures – Insights From Şanlıurfa

Abstract

Background and Objective: Intertrochanteric femur fractures are severe injuries, particularly affecting the elderly population, and are associated with high morbidity and mortality. Early surgical intervention has been reported to reduce these risks, yet regional differences' influence on patient demographics and clinical management remains debatable.Methods: A retrospective analysis was conducted on 305 patients treated for intertrochanteric femur fractures between 2015 and 2020 at Sanliurfa Mehmet Akif Inan Training and Research Hospital. Patients with a radiologically confirmed diagnosis of intertrochanteric femoral fracture, aged 50 years and older, with complete treatment records and follow-up data, were included. Demographic data (age, sex), clinical parameters (age at surgery, ASA score, comorbidities), time from hospital admission to surgery, and follow-up time and mortality status were meticulously collected from patient records.Results: Mortality was observed in 36 patients. No significant differences in mortality were found between the sexes or in postoperative intensive care requirements. However, patients with higher ASA scores and multiple comorbidities exhibited a significantly increased risk of mortality (OR: 1.8, 95% CI: 1.2-2.6, p =0.004). Additionally, A longer time to surgery was observed in the mortality group (28.4 ± 8.3 hours vs. 20.6 ± 6.2 hours, p = 0.002); however, whether this delay itself contributed to mortality or reflected pre-existing medical instability requiring preoperative optimization could not be determined in this retrospective study.Conclusions: This study highlights the importance of early surgical intervention and comprehensive risk assessment in reducing mortality in patients with intertrochanteric femoral fractures. The findings underscore the need for optimized clinical management strategies tailored to regional healthcare conditions to improve patient outcomes.