Vital prognosis in fractures of the proximal femur. Study in 506 patients of 60 years of age and over

: Five hundred and six patients aged 60 years or over admitted to hospital between 1977 and 1982 for a fracture of the upper end of the femur were the subject of a retrospective study to determine their mortality. Those with multiple injuries or affected by a pathological fracture were excluded. The median age of the population was 80 years, with a clear female predominance. Ageing appeared to be the main risk factor in fracture of the upper end of the femur. Surgical treatment was early, at a median of two days, and weightbearing was possible on the fifth day for half of the patients. The mean time in the surgical department was 15 days, followed by transfer to a nursing home or to a rehabilitation unit for two-thirds of the patients; 7.9 p. cent of patients died during their stay in the surgical department. The actuarial survival rate at one year was 64.7 p. cent and at five years was 35.3 per cent. Compared with the corresponding general population, a fracture of the upper end of the femur is accompanied by a persistently higher mortality for at least two years after the accident, more marked in relative values in men and in younger subjects. A multifactorial study of the prognostic factors using Cox's model showed that the mortality rose with age at the time of the fracture but was lower when the patient had previously been able to go out of the house and was of the female sex.(ABSTRACT TRUNCATED AT 250 WORDS)