Influencing factors for postoperative prognosis of elderly patients with femoral intertrochanteric fracture in Xinjiang，China

Abstract:

Objective：To investigate the main factors for the postoperative survival rate of elderly patients with femoral intertrochanteric fracture in Xinjiang，China through a retrospective analysis of their clinical data after surgery. Methods：A retrospective analysis was performed for the clinical data of 131 patients who underwent surgical treatment in The First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2017. The Kaplan-Meier method was used to calculate survival rates at 6 months，1 year，3 years，and 5 years after surgery. Cumulative survival rate was calculated and survival curves were plotted. A univariate analysis was performed. The log-rank test was used for comparison between groups，and the Cox regression analysis was used for the multivariate analysis. Results：The survival rates at 6 months，1 year，3 years，and 5 years after surgery were 87.0%（95%CI＝81.3%-92.7%），80.6%（95%CI＝73.7%-87.5%），65.1%（95%CI＝55.7%-74.5%），and 52.1%（95%CI＝37.4%-66.8%），respectively. The univariate analysis showed that age（ ?字2=18.190，P=0.000），number of chronic comorbidities（ ?字2=36.142，P=0.000），presence of nervous system disease （ ?字2=4.093，P=0.043），presence of renal insufficiency（ ?字2 =11.992，P=0.001），preoperative albumin level（ ?字2 =3.872，P=0.049），Ameri－can Society of Anesthesiologists score（ASA）（ ?字2=7.369，P=0.025），length of stay in the intensive care unit（ICU）（ ?字2=24.474，P=0.000） were influencing factors for the postoperative survival rate of elderly patients with femoral intertrochanteric fracture. The multivariate analysis showed that ≥3 chronic comorbidities（hazard ratio[HR]=5.133，95%CI＝2.690-9.790，P=0.000） and a length of stay in the ICU of ≥36 hours（HR=9.229，95%CI＝2.546-33.457，P=0.001） were independent risk factors for poor postoperative prognosis of elderly patients with femoral intertrochanteric fracture. Conclusion：There are various influencing factors for the postoperative survival rate of elderly patients with femoral intertrochanteric fracture. With reference to local medical conditions and patient’s individual conditions，physicians should strengthen multidisciplinary collaboration and select appropriate treatment plans，so as to improve postoperative quality of life，prolong survival time，and improve prognosis.