Comorbid medical illnesses associated with proximal femur fractures in elderly population

INTRODUCTION: Falls in the elderly are an important health problem, regardless of the cause. They are a significant cause of concern and contribute to both morbidity and mortality. The aim of this study was to understand the comorbidities, medication history, and other clinically important risk factors associated with such falls/fractures and their correlation with 30-day patient mortality. MATERIALS AND METHODS: An 18-month study was conducted on 200 elderly patients, more than 60 years of age, admitted as proximal femur fractures in a medical school hospital. A proper history, detailed clinical examination, and relevant investigations were done to establish the diagnosis of fracture and a particular comorbid condition. The grading of comorbidity and its correlation with prevalence of proximal femur fractures and 30-day mortality was performed according to Charlson Comorbidity Index. RESULTS: Of a total of 200 patients, 84 patients (42%) had a fractured neck of femur, 100 patients(50%) had a fracture intertrochanter and 16 patients(8%) had a fracture subtrochanter. Our study showed that 12.5% of the patients had no comorbidities, 31.25% had one comorbidity, 22.5% of the patients had two comorbidities, 20% of the patients had three comorbidities and 12.5% of the patients had more than or equal to 4 comorbidities. Hypertension, followed by diabetes, was the most prevalent comorbidity and hyponatremia was the most common electrolyte abnormality. 13.5% of the patients died in hospital within the first 30 days of fracture and these patients had a statistically significant and higher CCI compared to the survivors. CONCLUSIONS: We concluded that a huge burden of comorbidities had a positive correlation with 30-day mortality. Hypertension followed by diabetes was the commonest comorbidity, patients who expired in-hospital within the first 30 days of fracture had a statistically significant and higher CCI compared to the survivors in the same period of time. It was also concluded that increased age had a statistically significant positive correlation with mortality.