Mortality is lower after acetabular vs proximal femoral fractures in older patients
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Compared with proximal femoral fractures, acetabular fractures were linked with lower 1-year mortality rates in older patients despite being associated with a higher complication rate, according to published results.
Researchers compared data from a group of 129 patients with acetabular fractures (mean age of 78 years) and 129 patients with proximal femoral fractures (mean age of 77 years).
According to the study, outcome measures included cumulative 1-year mortality (evaluated with the Kaplan Meier survivorship analysis) and perioperative complications. Additionally, researchers performed Cox proportional hazard modeling to identify factors associated with increased 1-year mortality.
Researchers found the acetabular fracture cohort had lower cumulative 1-year mortality both before matching (18% for acetabular fractures vs. 33% for proximal femoral fractures) and after matching (18% vs. 36%, respectively.) However, they noted a “signicantly higher” overall perioperative complication rate in the acetabular fracture cohort (68%) compared with the proximal femoral fracture cohort (48%).
“In our multivariable Cox regression analysis, older age, perioperative blood loss of greater than 1 L and wheelchair mobilization were associated with lower survival rates after acetabular fracture surgery,” the researchers wrote in the study. “Older age and a higher [five]-item modied frailty index were associated with a higher 1-year mortality rate after proximal femoral fractures, whereas postoperative full weight-bearing was protective,” they wrote.
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