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Objective <p>In spite of following multimodal treatment including medical, surgical intervention and physiotherapy, most elderly with proximal femur fractures do not regain their pre-fracture mobility and activity. This study found factors affecting post-surgical outcome following hip surgery over a 3-year follow-up.</p> Methods <p>Prospective observational cross-over study included 76 patients, ≥ 60&#xa0;years sustaining proximal femur fracture from November 2017 to April 2019 with an average 3-year follow-up. Decision for surgery was taken after an assessment by the orthopaedician, anaesthesiologist and physician. Patient mobility (Palmer and Parker score), disability (modified Barthel index) and post-operative complications and mortality were studied.</p> Results <p>On performing multivariate regression, the following was found: (a) age (years) was a significant independent risk factor of poor Parker and Palmer Score {6&#xa0;months} and poor Barthel index {6&#xa0;months} after adjusting for confounding factors [OR 1.12 (1.029–1.22) and 1.13 (1.021–1.25)]. (b) Age (years) and pre-operative Parker and Palmer score were significant independent risk factors of poor Parker and Palmer Score {1&#xa0;year} after adjusting for confounding factors [OR 1.129 (1.017–1.252) and 0.597 (0.379–0.939)]. (c) Increase in pre-operative Barthel index score by 1 unit, duration of hospital stay significantly decreased by 0.148&#xa0;days and American Society of Anaesthesiologists (ASA) classification (3, 4) had significantly high duration of hospital stay [beta coefficient of 3.642 (1.155–6.13)].</p> Conclusion <p>Pre-operative Parker and Palmer score and age are independent risk factors for post-surgical outcome, while ASA classification (3, 4) and pre-operative modified Barthel index score are independent risk factors for duration of hospital stay.</p>

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Factors Affecting Outcome of Proximal Femoral Fracture Surgery Among the Elderly

  • 期刊论文

  • 发表日期：

    2025年8月31日

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  • Max K. Shibu,
  • Bobby John,
  • Karanveer Singla,
  • Vishal Sharma

摘要

Objective

In spite of following multimodal treatment including medical, surgical intervention and physiotherapy, most elderly with proximal femur fractures do not regain their pre-fracture mobility and activity. This study found factors affecting post-surgical outcome following hip surgery over a 3-year follow-up.

Methods

Prospective observational cross-over study included 76 patients, ≥ 60 years sustaining proximal femur fracture from November 2017 to April 2019 with an average 3-year follow-up. Decision for surgery was taken after an assessment by the orthopaedician, anaesthesiologist and physician. Patient mobility (Palmer and Parker score), disability (modified Barthel index) and post-operative complications and mortality were studied.

Results

On performing multivariate regression, the following was found: (a) age (years) was a significant independent risk factor of poor Parker and Palmer Score {6 months} and poor Barthel index {6 months} after adjusting for confounding factors [OR 1.12 (1.029–1.22) and 1.13 (1.021–1.25)]. (b) Age (years) and pre-operative Parker and Palmer score were significant independent risk factors of poor Parker and Palmer Score {1 year} after adjusting for confounding factors [OR 1.129 (1.017–1.252) and 0.597 (0.379–0.939)]. (c) Increase in pre-operative Barthel index score by 1 unit, duration of hospital stay significantly decreased by 0.148 days and American Society of Anaesthesiologists (ASA) classification (3, 4) had significantly high duration of hospital stay [beta coefficient of 3.642 (1.155–6.13)].

Conclusion

Pre-operative Parker and Palmer score and age are independent risk factors for post-surgical outcome, while ASA classification (3, 4) and pre-operative modified Barthel index score are independent risk factors for duration of hospital stay.