Mortality and ambulatory status after intertrochanteric fracture treated at Maharat Nakhon Ratchasima Hospital, Thailand

Purpose: 1. To assess elderly intertrochanteric fracture patients for overall one-year mortality rate and for ambulatory ability two years after treatment. 2. To analyze factors that may affect one-year mortality and independent walking. 3. To compare one-year mortality, survival function, and independent walking between operative and home skin traction treatment. Methods: A retrospective cohort study of 496 intertrochanteric fracture patients at least 60 years of age, treated at Maharat Nakhon Ratchasima Hospital between October 2002 and September 2006, assessed one-year mortality rate and two-year ambulatory ability. The factors studied were treatment methods (251 operation, 245 home skin traction), gender (337 female, 159 male), age (mean 78 years, SD8.7), numbers of comorbidities (57 % had one or more comorbidities), and ASA classification (ASA I, II, III, and IV were 55%, 36.7%, 7.5%, and 0.8 % respectively). Results: The overall one-year mortality rate was 23.6%. The median survival time was 4.18 years after fracture. Of patients who were still alive two years later, 55.2 % could walk independently, 27.7 % needed assistance or gait aids, and 17.1 % were confined to bed or wheelchair. Factors that significantly affected one-year mortality were nonoperative treatment, being male, and each additional year of age. The home traction group had