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. 2024 Sep 18;14(9):991.
doi: 10.3390/jpm14090991.

The Impact of Frailty and Gender Differences on Hospitalization and Complications in Proximal Femoral Pathological Fractures: A Cross-Sectional Study

Alessandro El Motassime  1 , Elisa Pesare  2 , Andrea Russo  3 , Sara Salini  3 , Giordana Gava  1 , Carla Recupero  1 , Tommaso Giani  1 , Marcello Covino  4 , Giulio Maccauro  1 , Raffaele Vitiello  1
Affiliations

The Impact of Frailty and Gender Differences on Hospitalization and Complications in Proximal Femoral Pathological Fractures: A Cross-Sectional Study

Alessandro El Motassime et al. J Pers Med. .

Abstract

Background: Frailty associated with aging increases the risk of falls, disability, and death. The aim of this study is to explore gender-related disparities in the survival outcomes of pathological femoral fractures in older frail patients, while analyzing potential specific prognostic factors.

Methods: This study is a retrospective observational analysis conducted at a single medical center. It enrolled all patients aged 65 and above who were admitted to our emergency department between 2016 and 2020 with a diagnosis of pathological femur fracture requiring surgical intervention. The primary study endpoint was evaluating gender-related differences in survival outcomes. The secondary endpoint involves investigating gender-specific prognostic factors through the analysis of clinical and laboratory parameters.

Results: The average Charlson Comorbidity Index (CCI) was slightly lower in men, but the difference was not statistically significant (p = 0.53). The Clinical Frailty Scale (CFS) showed similar results, with men and women 5.23 (SD 1.46), also not significant (p = 0.83). An evaluation comparing patients aged 75 years or younger to those older than 75 years found significant differences in health metrics. The average CCI was higher in the over 75 group compared to the under 75 group, with a p-value of 0.001. Similarly, the CFS average was also greater in the over 75 group than in the under 75 group, with a p-value of 0.0001. Complications were more frequent in patients over 75 and those with lower educational qualifications. The evaluation analyzed cardiac patients compared to a control group, revealing that the average age of cardiac patients was 75.22 years, while the control group was younger at 73.98 years (p = 0.5119). The CCI for cardiac patients averaged 6.53, significantly higher than 4.43 for non-cardiac patients (p = 0.0003).

Conclusion: Frailty assessment is therefore essential in patients with pathological fracture of the proximal femur and is an important predictor of both gender differences and hospital complications. Enhancing gender analysis in this field is crucial to gather more robust evidence and deeper comprehension of potential sex- and gender-based disparities.

Keywords: femur fractures; frailty; gender; pathological fractures.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

References

    1. Fischer H., Maleitzke T., Eder C., Ahmad S., Stöckle U., Braun K.F. Management of Proximal Femur Fractures in the Elderly: Current Concepts and Treatment Options. Eur. J. Med. Res. 2021;26:86. doi: 10.1186/s40001-021-00556-0. - DOI - PMC - PubMed
    1. Piscitelli P., Iolascon G., Gimigliano F., Muratore M., Camboa P., Borgia O., Forcina B., Fitto F., Robaud V., Termini G., et al. Incidence and Costs of Hip Fractures Compared to Acute Myocardial Infarction in the Italian population: A 4-year Survey. Osteoporos. Int. 2007;18:211–219. doi: 10.1007/s00198-006-0224-9. - DOI - PubMed
    1. Guzon-Illescas O., Perez Fernandez E., Crespí Villarias N., Quirós Donate F.J., Peña M., Alonso-Blas C., García-Vadillo A., Mazzucchelli R. Mortality after Osteoporotic Hip Fracture: Incidence, Trends, and Associated Factors. J. Orthop. Surg. Res. 2019;14:203. doi: 10.1186/s13018-019-1226-6. - DOI - PMC - PubMed
    1. Mitchell R., Harvey L., Brodaty H., Draper B., Close J. Hip Fracture and the Influence of Dementia on Health Outcomes and Access to Hospital-based Rehabilitation for Older Individuals. Disabil. Rehabil. 2016;38:2286–2295. doi: 10.3109/09638288.2015.1123306. - DOI - PubMed
    1. Goldacre M.J., Roberts S.E., Yeates D. Mortality after Admission to Hospital with Fractured Neck of Femur: Database Study. Br. Med. J. 2002;325:868–869. doi: 10.1136/bmj.325.7369.868. - DOI - PMC - PubMed

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