To evaluate the 1-year mortality
of elderly patients
after isolated acetabular fractures treated both operatively and nonoperatively, and compared with nonisolated fractures.
Single level 1 trauma center.
All consecutive patients who were 60 years of age and older were treated for acetabular fractures over a 12-year period (n = 176).
Operative and nonoperative management.
Main Outcome Measurements:
Exclusion criteria for the isolated group included associated injuries to other body systems (Abbreviated Injury Score >2), long bone fractures, and concurrent sacral fractures. Mortality
data were obtained from the Social Security Death Index.
The isolated group (n = 86) had an average age of 71.1 ± 7.1 years with 64.0% fractures treated operatively. Mortality
rates for the isolated group at 30 days, 3 months, 6 months, and 1 year were 2.3%, 5.8%, 8.1%, and 8.1%, respectively. No significant differences in mortality
rates were seen between operative and nonoperative patients across all time points for the isolated group (P
= 0.093–0.346). Mortality
rates were lower at all time points for the isolated group than for the nonisolated group (n = 90; P
= 0.0002–0.02). However, the 1-year postdischarge mortality
rates for patients who were discharged from the hospital were similar for the nonisolated and isolated groups (6.8% vs. 7.1%; P
rates for elderly patients
with isolated acetabular fractures were found to be significantly lower than those for acetabular fractures with concurrent injuries. Age was identified as the only significant variable differing between patients treated operatively versus nonoperatively, as opposed to medical comorbidities in the isolated acetabular fracture
Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.