Incidence and Risk Factors of Mortality in Nonagenarians and Centenarians After Intertrochanteric Fracture: 2-Year Follow-Up

PURPOSE: The purpose of this study was to explore risk factors for mortality after intertrochanteric fracture (IF) surgery in nonagenarians and centenarians based on subgroups of follow-up time. PATIENTS AND METHODS: A total of 144 nonagenarians and centenarians who underwent IF surgery between Jan. 2014 and Dec. 2018 were included. Data were compared between the mortality and the survival groups based on the subgroups of follow-up time in univariate, logistic regression, and Cox regression analyses. RESULTS: In our study, the rates of mortality were 7.6%, 13.9%, and 28.5% at 6-month, 1-year, and 2-year follow-up, respectively. Univariate analysis showed that prolonged time from injury to surgery, more transfusion volume, lower hemoglobin (minimum), and complications (respiratory failure and anemia) were associated with mortality at 6-month follow-up. However, three factors were found to be related to mortality at 1-year and 2-year follow-up, respectively. Our results showed that postoperative respiratory failure and anemia were independent risk factors for mortality after IF surgery at 6-month in logistic regression analysis. However, postoperative respiratory failure was found as an independent risk factor for mortality at 1-year and 2-year follow-up. Moreover, Cox regression analysis showed that postoperative respiratory failure was an independent risk factor for mortality after IF surgery, which was consistent with results in logistic regression analysis. CONCLUSION: Postoperative respiratory failure was an independent risk factor for mortality in nonagenarians and centenarians at any follow-up. Additionally, postoperative anemia was closely related to mortality. Preoperative measures should be taken to lower mortality.