| Abstrakt: |
Introduction: Fracture of neck of femur is common among the elderly in Brunei Darussalam. While the 1 year mortality and factors affecting it have been extensively studied across the world, such information is not available for Brunei Darussalam. This study aimed to assess the mortality after neck of femur fracture and analyse various variables including gender, age, type of fracture, comorbidities, time delay and ASA grade related to mortality. Methods: In a retrospective study, data on elderly patients with a fracture neck of femur admitted to the tertiary referral centre from January 2014 to December 2018 was analysed. Eligibility of patients include those aged 60 and above, and admitted with fragility fracture of the neck of femur. Patients with the ICD-10 diagnosis codes of S72.0, S72, S72.1 were identified and relevant information was obtained from Bru-HIMS (Brunei Health Information and Management Systems) database. Results: Over the study period 353 patients were recorded with fracture neck of femur and 222 were found eligible for the study. A median of 53 cases were recorded annually for a population of approximately 421,300 (in 2017). The mortality at 1 year was 19.4% (51/222) and higher in women (70.6%). The most common co-morbidities were hypertension, type 2 diabetes mellitus and hyperlipidaemia. Surgical delay of more than 7 days (42% of cases) and higher ASA grades were significantly associated with higher risk of mortality. The reasons for delay in surgery were for optimization of patient, stoppage of anticoagulants and in some cases availability of Operating Room facility. Conclusion: In agreement with the literature, the 1 year mortality after fracture of neck of femur was 19.4% and was significantly related to delay in surgery and higher ASA grade. Efforts are being made to reduce the delay to the internationally recommended time frame through a multidisciplinary team lead by Geriatricians. [ABSTRACT FROM AUTHOR] |
