Research Paper Volume 12, Issue 13 pp 13583—13593

Super elderly patients with intertrochanteric fractures do not predict worse outcomes and higher mortality than elderly patients: a propensity score matched analysis

Junfei Guo1, *, , Zhiqian Wang1, *, , Mingming Fu1, , Jun Di1, , Junpu Zha1, , Junchuan Liu1, , Guolei Zhang1, , Qingxian Wang1, , Hua Chen2, , Peifu Tang2, , Zhiyong Hou1, , Yingze Zhang1,3, ,

  • 1 Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, P.R. China
  • 2 Department of Orthopaedic Surgery, Chinese PLA General Hospital, 301 Hospital, Beijing 100853, P.R. China
  • 3 Chinese Academy of Engineering, Beijing 100088, P.R. China
* Equal contribution

Received: March 3, 2020       Accepted: May 27, 2020       Published: July 10, 2020
How to Cite

Copyright © 2020 Guo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


We aimed to investigate whether super elderly patients aged over 90 years had significantly worse functional outcomes, perioperative complications, and survival rates. Among 3560 patients aged over 65 years presenting with intertrochanteric fractures and treated surgically between Jan 2014 and Jan 2019, 2242 patients were included, including 206 in super elderly group and 2036 in elderly group. After using propensity score matching to minimize the effects of possible confounding variables, 192 remained in each group. No significant difference was observed in functional outcomes, perioperative complications, or 30-day, 90-day, and 1-year mortality after propensity score matching and McNemar’s tests (p>0.05). After an average follow-up of 37 months, the Kaplan-Meier survival curve showed no significant difference between the two groups in terms of cumulative survival rate (p=0.081, log-rank). Our data demonstrated progressive increases in mortality and poor outcomes with increasing Elixhauser comorbidity scores, which represented the severity index of patients preoperatively. Our study also found that there were weak correlations between five characteristics and the patient age. These results all suggested that it is not the advanced age itself but other concomitant factors, that appear to be responsible for the adverse functional outcomes, perioperative complications, and mortality in super elderly patients.


ASA: American Society of Anesthesiologists; BMI: body mass index; PSM: propensity score matching; PFNA: proximal femoral nail anti-rotation.