Ganhao et al reported factors predictive of adverse outcomes for a geriatric patient with a proximal femur fracture. These can help to identify a patient who may require more aggressive management and rehabilitation. The authors are from multiple institutions in Porto, Portugal.
Patient selection: age >= 65 years with fragility/osteoporotic fracture of the proximal femur
Predictors of refracture:
(1) neurologic disease (HR 2.3)
(2) COPD (HR 3.6)
Predictors of mortality:
(1) male sex (HR 1.6)
(2) older age (> 80 years, HR 1.5)
(3) greater dependency (HR 1.2)
(4) bone mass density (T score), HR 4.0 for low density and HR 0.6 for T score
(5) comorbidities (Charlson comorbidity index, HR 2.1)
(6) diabetes
(7) heart failure (HR 2.4)
(8) beta-crosslaps (a serum test for osteoporosis, HR 2.0)
Factors associated with lower risk of mortality:
(1) fracture type (HR 0.45 for femoral neck fracture)
