Epidemiological trends in the clinical features of intertrochanteric fractures: a hospital-based retrospective study / 中华骨科杂志

ABSTRACT

Objective:To analyze the epidemiological characteristics of all the patients with intertrochanteric fracture admitted to the Third Hospital of Heibei Medical University in the past 10 years.Methods:Data of patients with intertrochanteric fracture admitted to our hospital from January 1, 2010 to December 31, 2019 were retrospectively analyzed. According to the year of admission, all the patients were divided into two groups the first five years (group A) and the last five years (group B). Gender, age, injury cause, Evans classification, complicated diseases, length of hospital stay and whether surgical treatment or not were compared.Results:A total of 6,125 patients with intertrochanteric fracture were included in the study, including 2,664 males and 3,461 females with a male to female ratio of 0.77∶1. The peak age was 70-79 for males and 80-89 for females. There were 2,314 cases in group A (male to female ratio was 0.91∶1) and 3,811 cases in group B (0.70∶1), showing significant differences between the 2 groups in the male to female ratio ( χ2=25.265, P< 0.05). The peak age ranged from 70 to 80 years (31.9%,739/2,314) in group A and from 80 to 90 years (34.5%, 1,313/3,811) in group B. There were significant differences between the 2 groups in the sex ratios of age groups from 70 to 79 years ( χ2=0.024, P< 0.05). In all the 6,152 patients with a definite injury cause, the fall and indoor activity accounted for the highest proportion (83.9%, 5,140/6,125), and the proportion of group A was 75.4% (1,745/2,314) while the proportion of group B was 89.1%(3,395/3,811) showing a significant differences between the 2 groups in injury cause ( χ2=14.363, P< 0.05). Based on X-ray films or computer tomography (CT) of 3,560 patients, the Evans type II and III were the most common types. Type II accounted for the highest proportion in group A (38.1%, 239/628) while type III did in group B (39.5%, 1,159/2,932) . There were significant differences between the 2 groups in the proportion of Evans classification ( χ2=183.569, P< 0.05). Of all the 6,125 fracture cases, 4,846 fracture patients (79.1%) were complicated with medical diseases. There was a statistically significant difference between the 2 group of the patients who were complicated with medical diseases ( χ2=8.916, P< 0.05). A total of 5,148 patients were treated by operation and 1,925 patients were in group A while the other 3,259 cases were in group B. In group A, the median hospitalization was 14 days and the quartile interval was 8 days. In group B, the median hospitalization and the quartile interval was 12 days and 8 days respectively. There were significant differences between the 2 groups in length of hospital stay for patients treated by surgery ( Z=-9.909, P<0.001). Conclusion:The intertrochanteric fractures admitted to the Third Hospital of Heibei Medical University in the past 10 years were more common in females than in males. Fall and indoor activity was the most common injury cause. Evans types II and III prevailed. The fractures showed an aging trend by comparing the former 5 years and latter 5 years. The number of intertrochanteric fracture patients complicated with medical diseases increased significantly, but the total days of hospitalization was on the decline.