Proximal Femoral Fracture Surgery in Older Bedouin Adults in Southern Israel: One-Year Mortality and Predictors

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OBJECTIVE: Proximal femoral neck fractures are known to increase mortality rates among the older population. The aim of this study was to investigate the one-year postoperative mortality rates following proximal femoral neck fracture repair surgery in the underserved Bedouin population of the Negev, Israel. METHODS: A retrospective observational cohort study examining 1-year postoperative mortality following proximal femoral neck fracture surgery in the Bedouin population aged 65 and older at Soroka University Medical Center from 2013 to 2020. The univariate analyses utilized Student's t-test for continuous variables and the chi-square test for categorical variables. Significant variables identified in the univariate analysis were incorporated into a multivariate logistic regression model to identify independent predictors of mortality. TRIAL REGISTRATION NUMBER: 0236-20-SOR; date of registration: May 30, 2021; retrospectively registered. RESULTS: The one-year postoperative mortality rate was 23.4%. Univariate analysis revealed that non-survivors were significantly older, predominantly male, had lower body mass indices, reduced lymphocyte counts, and higher comorbidity scores. Multivariate analysis revealed that only age and male sex were independent predictors of mortality, with each additional year of age increasing the risk by 8% (OR = 0.92, p = 0.042), and men having a 3.9-fold greater risk compared to women (OR = 3.9, p = 0.032). CONCLUSIONS: In the Bedouin population of the Negev, Southern Israel, age and male sex are the main determinants of 1-year mortality following proximal femoral neck fracture surgery, with rates comparable to those observed in other populations.

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