Morbidity and Mortality in Intertrochanteric Hip Fractures Treated With Cephalo-medullary Nailing. Predictive Value of the Parker Mobility Score
DOI:
https://doi.org/10.15417/issn.1852-7434.2023.88.5.1681Keywords:
Intertrochanteric hip fracture, morbidity, mortality, cephalo-medullary nailing, Parker Mobility ScoreAbstract
Introduction: Hip fracture represents an independent predictor of morbidity and mortality. The aim of this retrospective study was to assess the morbidity and mortality associated with intertrochanteric hip fractures fixed with cephalomedullary nails.
Materials and Methods: We analyzed all patients treated between 2018 and 2021 with a cephalomedullary nail for an intertrochanteric hip fracture, with a minimum follow-up of 12 months. We evaluated the demographic data, comorbidities, functional level through the Parker Mobility Score (PMS), complications, and mortality (12 months and at the end of follow-up). Variables related to postoperative complications or death were identified by bivariate and multivariate regression analyses.
Results: 68 patients were included. The mean follow-up was 23 (range 12-40) months. The rate of complications was 8.8% (n=6), 1 urinary tract infection, 1 pneumonia, 1 deep vein thrombosis, and 3 (4.4%) cephalic screw fixation losses. Patients who had complications presented significant differences in age at the time of fracture. Mortality at 12 months and at the end of the study was 2.9% (n=2) and 29.4% (n=20) respectively. Those patients who died presented significant differences in the incidence of kidney
comorbidities, dementia, a Charlson Comorbidity Index > 4, and a PMS < 5. PMS < 5 was the only independent variable related to mortality.
Conclusions: Cephalomedullary nailing in unstable intertrochanteric hip fractures in elderly patients represents a treatment option that offers an acceptable complication rate and a low 12-month mortality rate. The risk of death is significantly increased in patients with low functional scores (Parker < 5) pre-fracture.
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