ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Frailty as a determinant of mortality, surgical timing and hospital stay in proximal femur fractures: a retrospective cohort study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Sudden Cardiac Arrest in Proximal Femur Fracture: The Role of Admission Blood Parameters.Cureus · 2026Article
- Hip Fracture as a Systemic Disease in Older Adults: A Narrative Review on Multisystem Implications and Management.Medical sciences (Basel, Switzerland) · 2025Review
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10 authors.
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Abstract
backgroundProximal femur fractures are common in elderly patients and are strongly associated with frailty, increased mortality, and functional decline. The Clinical Frailty Scale (CFS) has emerged as a key predictor of outcomes, influencing perioperative management and rehabilitation strategies. This study aims to evaluate the impact of frailty on mortality, surgical timing, and length of hospital stay (LOS) in patients with hip fractures.
methodsThis single-center retrospective study analyzed data from patients aged ≥ 65 years admitted with AO type 31A and 31B proximal femur fractures between 2018 and 2023. Patients were stratified according to CFS scores to assess the relationship between frailty and in-hospital mortality, surgical delay, and LOS. Multivariate logistic regression was performed to identify independent risk factors.
resultsAmong 2312 patients (median age: 85 years), frailty was a significant predictor of mortality (p = 0.019). Patients with CFS 7-9 had a 6.6-fold higher mortality risk than those with CFS 1-3. Delays in surgery beyond 48 h were associated with a doubled risk of mortality (p = 0.009), particularly in frail patients. Prolonged LOS (> 7.1 days) correlated with an increased incidence of infections, cardiovascular events, and mortality (p < 0.001).
conclusionsFrailty significantly impacts hip fracture prognosis in elderly patients, increasing mortality, complications, and LOS. Early identification of frail patients and prioritization of timely surgery are crucial to improving outcomes. Future studies should explore tailored surgical strategies and optimized rehabilitation protocols to enhance recovery in this high-risk population.
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