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Surgical treatment of proximal femoral fractures in centenarians: prevalence and outcomes based on a German multicenter study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to estimate the survival rate after proximal femoral fracture insult and identify the subgroup of centenarians with a high risk.

Methods

Records of patients (≥ 65 years) who underwent surgery for PFF between 2006 and 2020 were retrieved from the electronic databases of three hospitals. Overall, 22 demographic, perioperative, and postoperative variables were analyzed for all patients > 99 years of age. The effect of anemia, time to surgery, surgical procedure, place of residence, and dementia on complications and survival were evaluated.

Results

The study included 85 patients (women n = 71; men n = 14; median age, 100 years; range 100–106 years). Over the study period, the prevalence of centenarians with PFF increased (0.94%). The overall complication rate was 28% (in-hospital death, n = 16; infection, n = 1; hematoma, n = 1; implant failure, n = 1; cardiac decompensation, n = 3; pneumonia with delirium, n = 1; urinary tract infection, n = 1). The 30-day, 3-month, 6-month, and 1-year mortality rates for the study group were 27.1%, 42.4%, 55.3%, and 61.2%, respectively. Median survival was 150 days (range 1–1942 days). Patients with dementia (n = 47) had a shorter survival time than patients without dementia (n = 38) (hazard ratio 1.75; 95% confidence interval 1.04, 2.95). Preoperative anemia, time to surgery, or necessary surgical procedure had no impact on survival.

Conclusions

The prevalence of centenarians undergoing surgery for PFF is increasing. In-hospital mortality is high, and dementia is a risk factor impacting survival. The rates of surgical revision and general complications are low, and the chosen predictors had no significant impact on these outcomes. The survival rate after discharge from hospital seems to be comparable to the estimated survival rate of uninjured centenarians.

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Data availability

Data are available on request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing. We would like to thank CRO Dr. med. Kottmann GmbH & Co. KG (Beverstrasse 64, 59077 Hamm, Germany) for statistical work.

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hegau-Bodensee-Klinikum Singen, Virchowstrasse 10, 78224, Singen, Germany

    Ronny Langenhan & Axel Probst

  2. Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany

    Franz Müller & Bernd Füchtmeier

  3. Department of Orthopaedic Surgery, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Germany

    Ludwig Schütz & Niklas Reimers

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  1. Ronny Langenhan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by RL, FM, and NR. The first draft of the manuscript was written by RL and NR. All authors commented on and revised versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ronny Langenhan.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study was approved by the responsible ethics committee (approval number: LÄK BW, F-2016–068) and is in accordance with the Helsinki Declaration in 1964 and its later amendments.

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Informed consent was obtained from all individual participants included in the study or their legal guardians. Data were processed under German national terms and regulations.

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Informed consent was obtained from all individual participants included in the study or their legal guardians.

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Langenhan, R., Müller, F., Füchtmeier, B. et al. Surgical treatment of proximal femoral fractures in centenarians: prevalence and outcomes based on a German multicenter study. Eur J Trauma Emerg Surg 49, 1407–1416 (2023). https://doi.org/10.1007/s00068-022-02184-7

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  • DOI: https://doi.org/10.1007/s00068-022-02184-7

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