ภาวะแทรกซ้อน ปัจจัยที่สัมพันธ์ และอัตราการเสียชีวิตภายใน 1 ปี ในผู้ป่วยสูงอายุที่มีกระดูกสะโพกหักและได้รับการรักษาแบบไม่ผ่าตัดในโรงพยาบาลเสลภูมิ

Siwapong  Seskhumbong

Authors

Siwapong Seskhumbong Selaphum Hospital

Keywords:

Hip fracture, Non-operative management, Complication, Mortality

Abstract

Purposes : To evaluate the incidence of complications, 1-year mortality, functional outcomes, and associated factors in elderly patients with hip fractures treated non-operatively.

Study design : A retrospective cohort study.

Materials and Methods : This study was conducted at Selaphum Hospital and included patients aged ≥60 years who were diagnosed with hip fractures between 2019 and 2024. A total of 223 patients were identified, of whom 90 patients who received non-operative management were included in the study. Data were collected from medical records. Logistic regression analysis was performed to identify factors associated with complications, and odds ratios (ORs) with 95% confidence intervals (CIs) were reported.

Main findings : A total of 90 patients were included, with a mean age of 79.0 ± 8.1 years, and 68.9% were female. Complications within 1 year occurred in 68.9% of patients, with the most common being pressure sore (37.8%), pneumonia (18.9%), and urinary tract infection (8.9%). No statistically significant factors were associated with complications. However, increasing age showed a trend toward higher risk (Adjusted OR = 1.06, 95%CI: 0.99–1.13, p = .068). The 1-year mortality rate was 14.4%, and was higher among patients with complications compared to those without (16.1% vs. 10.7%), although this difference was not statistically significant. No patients regained independent ambulation at 1 year.

Conclusion and recommendations : Non-operative management of hip fractures in elderly patients is associated with a high rate of complications and poor functional outcomes. Appropriate patient selection and early preventive strategies are essential to improve outcomes.

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