Functional outcomes and survival rates of patients with fragility fractures of the pelvis: A multicenter retrospective analysis of 588 patients.

Abstract

This study evaluated the 1-year mortality rate and decrease in walking ability in older patients with fragility fractures of the pelvis (FFPs), considering the impact of demographic factors and treatment strategies on clinical outcomes. Conducted across 12 hospitals from 2014 to 2020, this retrospective analysis included 588 FFP patients aged over 65 years. Mortality and mobility were assessed according to patient demographic factors, the Charlson Comorbidity Index (CCI), and radiographic findings. A subgroup analysis was also performed for patients with unstable Type III and IV fractures to compare outcomes between surgical and conservative treatment. The study revealed a one-year survival rate of 91.6 %. A lower body mass index (BMI) and a higher CCI were significantly correlated with increased mortality. Loss of walking ability was observed in 32.4 % of patients. Fracture type and preoperative walking ability were identified as significant prognostic factors. In the subgroup analysis of unstable fractures, no significant difference was found in survival or final walking ability. In older FFP patients, a lower BMI and higher CCI predict greater mortality, and certain fracture types predict a decrease in walking ability. Surgical treatment did not significantly impact mortality or mobility outcomes, suggesting the need for careful consideration of treatment modalities. This study provides Level IV evidence from a retrospective cohort study on the factors influencing mortality and mobility in older patients with FFPs.