Background and Goal of Study
Hip fractures represent one of the most important causes of morbidity and mortality in elderly people. It is estimated that there were 1.66 million hip fractures worldwide in 1990, projected to be more than 6 million by the year 2050. Understanding the incidence of morbidity and mortality following hip fracture is essential to measuring elderly health and the value of improvements in health care. The aim of this study was to analyze the risk factors for morbidity and mortality.

Materials and Methods
We retrospectively analyzed 134 femoral neck fracture patients, admitted from January to December of 2016, who underwent urgent primary surgery. The primary outcome was
mortality at 30-day and 90-day and the secondary outcomes were complications during admission.

Results and Discussion: 
30-day mortality was 7,5% (10 patients) and 90-day mortality was 9,2% (12 patients). Postoperative morbidity was seen in 61 patients (45.5%). The factors associated with mortality were determined as preoperative serum albumin level, the presence of chronic obstructive lung disease, a high American Society of Anesthesiologist (ASA) score, postoperative hospital length of stay, postoperative gastrointestinal morbidity and immobilization (p < 0.05). Factors associated with increased postoperative morbidity included nursing home patients (OR 2.8), preoperative creatinine clearance (OR 8.55) and hemoglobin, intraoperative complications (OR 2.93) and minimum heart rate, postoperative creatinine clearance and hemoglobin, immobilization (OR 0.303), postoperative hospital length of stay and pre- and postoperative creatinine clearance variation (p < 0.05). In addition, the timing of surgery did not have a significant effect on 30-day mortality, 90-day mortality or complications arising during hospitalization (p > 0.05).

Conclusion(s): 
Early preoperative optimization of medical condition of patients with hip fracture before undergoing surgery is recommended. Identification of patient and perioperative factors can guide changes in best practice to decrease morbidity and mortality following a femoral neck fracture. There is a need for further studies concerning survival analysis to understand mortality rates in these patients.

10 / Morbidity and mortality after urgent hip fracture surgery – analysis of our environment