Mortality, complications and long-term functional outcome in elderly patients with fragility fractures of the acetabulum

Abstract

Background: Early operative treatment of acetabulum fractures in geriatric patients has been suggested to reduce pain and allow for earlier mobilization. The aim of this study was to determine mortality, complications and functional outcome after operative and non-operative treatment. Methods: Patients aged ≥60 years with operative treatment of low-energy fragility fracture of the acetabulum from 2009 to 2016 and a follow-up of at least 24 months were identified. The patients were contacted by phone and a modified Merle d'Aubigné score was obtained. If patients or their relatives were not available for follow-up, mortality data was assessed using a national social insurance database. Results: One hundred seventy-six patients (mean age 78, SD 10 years; 73 female) were available for analysis of mortality data. At final follow-up (68 months, SD 26, range, 24 to 129), 99/176 patients (56.3%) had deceased. One-year-mortality was 25.0% and 2-year mortality 35.8%. Type of treatment (non-operative vs. operative) did not affect mortality at 1 and 2 years (p =.65 and p =.10). Hospital-acquired infections were observed in 31/176 cases (17.6%), thromboembolic events and delirium in 6 patients (3.4%). In-hospital mortality was 5.7%. Patients who underwent operative treatment were more likely to have an in-hospital infection (p =.02) but less likely to sustain thromboembolic events (p =.03). The mean hospital stay was 14 days (SD 10 days, range, 1 to 66). Patients with operative treatment were longer hospitalized than patients with non-operative treatment (p