Clinical Characteristics and Outcomes of Geriatric Proximal Femur Fractures: A Retrospective Cohort Study at Ebrahim Haji Charitable Health Centre

Abstract

Introduction: Proximal femur fractures are a significant cause of morbidity and mortality among the elderly, often requiring prompt surgical intervention. This study aimed to evaluate the clinical characteristics, injury patterns, treatment modalities, and clinical outcomes of geriatric patients with proximal femur fractures treated at Ebrahim Haji Charitable Health Centre. Methodology: A retrospective analysis was conducted on all patients aged 60 years and above who sustained proximal femur fractures and were treated at the Ebrahim Haji Charitable Health Centre between January 2023 and December 2024. Data were collected using a structured form and included demographic details, injury mechanism, treatment type, surgical timelines, and post-operative outcomes (dichotomized Harris Hip Score and mortality at 1 year). Univariable and multivariable logistic regression analyses were conducted to identify predictors. Results: A total of 55 patients were included, with the majority being female (76.4%) and aged 75 years or older (56.4%). The predominant mechanism of injury was trivial falls (94.5%). Most patients presented to the hospital more than 24 hours after injury (67.3%), though 87.3% underwent surgery within 48 hours of admission. Intracapsular fractures were the most common diagnosis (50.9%) and the most common procedure carried out was arthroplasty (50.9%). Comorbidities were present in 69.1% of patients, with hypertension (50.9%) being the most common. Majority of the patients (80.0%) achieved a good Harris Hip Score at 1 year post surgery and the 1-year mortality rate was 10.9%. On multivariable analysis, female sex was independently associated with lower mortality (AOR 0.099, p = 0.036) while hemoglobin of ≤ 10g/dL was associated with increased mortality (AOR 17.888, p = 0.023). Diagnosis of intracapsular fracture was the only independent predictor of a good functional outcome (AOR 5.83, p=0.046). Conclusion: Geriatric proximal femur fractures at our center primarily affect elderly females and are most often due to low-energy falls. Low hemoglobin and male sex independently predict mortality, while intracapsular fractures independently predict better functional outcomes. These findings highlight the importance of early medical optimization prior to surgery.