The risk factors effecting mortality 1 year post operative in elderly patients with neck of femur fracture at Bhumibol adulyadej hospital.
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Abstract
The neck femur of femur fracture in elderly patient, Disease that increasing at presence elderly age society, bring the complication and lead the death to the old age patient in Thailand. Treatment at present, Surgery is a good choice to decrease complication and mortality rate but from the previous study there were some number of mortality rate. So far there have been no studies of risk factor, except operative management. The researcher tried to explore risk factor that correlated with mortality of patient neck of femur fracture.
Method: We collected data from the patient in patient formation in vary factor (age, gender, lymphocyte count, hemoglobin levels, mobilization time after surgery, length of stay, comorbidities, American Society of Anesthesiologists (ASA) rating of operative risk, and the time period between injury and surgery, vitamin D level). Then calculated relation between factor and mortality in patient 1 year post operative.
Result: There were 125 neck of femur fracture patients in bhumiphol hospital from July 2017 – June 2018. Divided to male 38 persons (30.4%) and female 87 persons (69.6%) Alive after 1 years 95 persons (76%) Death after 1 years 30 persons (24%) Hemoglobin level ≥ 10 g/dl 114 persons (91.2%) Hemoglobin level < 10 g/dl 11 persons (8.8%) albumin level ≥ 3.5 g/dl 101 persons (80.8%) albumin level < 3.5 g/dl 24 persons (19.2%) white blood cell in urine < 5-10 cell/HPF 72 persons (57.6%) white blood cell in urine ≥ 5-10 cell/HPF 53 persons (42.4% ) vitamin D level ≥ 25 ng/dl 44 persons (35.2%) vitamin D level < 25 ng/dl 81 persons (64.8 %) Age between 60 – 80 years 68 persons (54.4%) Age more than 80 years 57 persons (45.6%) Time before operate less than or equal to 7 days 85 persons (68%) Time before operate more than 7 days 40 persons (32%) Mobilization time after surgery less than or equal to 3 days 68 persons (54.4%) Mobilization time after surgery more than 3 days 57 persons (45.6%) length of stay less than or equal to 14 days 50 persons (40%) length of stay more than 14 days 75 persons (60%) American Society of Anesthesiologists classification ≤ 2 66 persons (52.8%) American Society of Anesthesiologists classification > 2 59 persons (47.2%) comorbidity ≤ 2 diseases 59 persons (47.2%) comorbidity > 2 diseases 66 persons (52.8%) lymphocyte count > 1500 cell/µL 53 persons (42.4%) lymphocyte count ≤ 1500 cell/µL 72 persons (57.6%)
Conclusion: The risk factor that corelate with mortality of patient neck of femur fracture 1 year post operative were albumin level, vitamin D level, mobilization time, length of stay, American Society of Anesthesiologists classification level, comorbidity and sex
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