RISK FACTORS FOR MORBIDITY AND MORTALITY IN PROXIMAL FEMORAL FRACTURES

Proximal femoral fractures (hip fractures) are a major public health concern, particularly in the elderly, due to their high morbidity and mortality rates. This retrospective descriptive study, conducted at the Mohammed V Military Teaching Hospital between January 2018 and June 2021, aimed to identify risk factors for short- and long-term morbidity and mortality in patients over 50 years of age undergoing surgery for proximal femoral fractures. A total of 125 patients were included in the study. The analysis revealed several significant risk factors for morbidity and mortality, including age over 70, anemia, preoperative renal insufficiency, and delayed treatment beyond 48 hours. Multivariate analysis indicated that treatment delay was the only statistically significant factor associated with postoperative morbidity and mortality (p=0.015). Postoperative complications were found to be associated with neurological, cardiovascular, respiratory, thromboembolic, and chronic pain, with significant relationships to anesthesia techniques, prolonged hospitalization, and pre-existing comorbidities. In-hospital mortality was 4%, with a 3-month mortality rate of 8.8% and a 1-year mortality rate of 20.8%. The study highlighted the impact of early surgical intervention, revealing that a delay in treatment by more than 48 hours was associated with a higher risk of complications and mortality. Furthermore, the study explored the influence of anesthesia techniques on patient outcomes, noting a slightly higher incidence of mortality in patients receiving general anesthesia compared to spinal anesthesia, though the difference was not statistically significant. The findings emphasize the importance of early intervention, identification of risk factors, and the need for multidisciplinary care to improve patient outcomes and reduce the burden of these fractures on healthcare systems.