Many studies have confirmed that the incidence of fractures of the proximal femur increases significantly with age and doubles every ten years after the age of 50. It was found out that these patients average age increases by one year every five years, and more than 50.00% with damage to this location are over 60 years old. The purpose of the study was to determine the regional correlation features of the interdependence of medical-epidemiological and anamnestic characteristics of patients with proximal femur fractures. Material and methods. To achieve the main goal, we conducted a retrospective study of patients with such fractures according to seven medical institutions in Kharkiv. Results and discussion. When studying the correlation levels of interdependence between various medical-epidemiological and anamnestic characteristics of the examined patients we stated that the female sex correlated with all age periods, which confirmed the predominance of females among the examined all age categories: the sex of patients determined reliable (average <0.001); forces correlation with age characteristics: k = 0.349; the possible influence of gender characteristics on the choice of treatment tactics was stated reliable (p = 0.003); the inverse weak correlation with the type of treatment was recorded: k = -0.041; the possibilities of the influence of age characteristics on comorbid burden; the presence of concomitant pathology and the choice of treatment tactics were clarified: it was determined that the age of the examined patients was significantly (p = 0.014) inversely weakly correlated with the presence of comorbidities and comorbid burden (respectively k = -0.050 (p < 0.001) and k = -0.047 (p <0.001)) and the type of treatment: k = -0.193 (p <0.001); possibilities of influence of more significant comorbid burden on indicators of levels of functional condition and increase in duration of terms of receipt to traumatological departments and reception of qualitative medical care were established: reliable (p <0.001) direct weak correlation was received between indicators of age of trauma and presence of concomitant diseases k = 0.081), comorbid load (k = 0.087) and functional state according to the ASA classification (k = 0.084); determined the stable effect of the existing concomitant pathology and comorbid burden at the level of functional status and its possible impact on using conservative treatment: the presence of comorbidities correlated strongly with comorbid burden (k = 0.989, p <0.001); functional state was evaluated according to ASA classification k = 0.985, p <0.001) and directly weak with the type of treatment (k = 0.228, p <0.001); a direct strong correlation was found between the comorbid burden and functional status according to the ASA classification and the type of treatment performed (respectively k = 0.979 and k = 0.226; p <0.001); the possible influence of low functional state on the choice of treatment tactics was stated: it was proved that the functional state significantly weakly correlated with the type of treatment: k = 0.229, p <0.001. Further research is planned to establish the possibility of predicting the use of treatment tactics and the development of reliable prognostic statistical models of the dependence of the results of different treatment methods on the medical-epidemiological and anamnestic characteristics of patients

Keywords: fractures of the proximal femur, clinical and epidemiological characteristics, concomitant pathology, comorbid burden, age-sexual characteristics, functional status

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1. Novik AA, Ionova TI. Rukovodstvo po issledovaniyu kachestva zhizni v meditsine [Guidelines for research on the quality of life in medicine]. Pod red akad YuL Shevchenko. 3-e izd, pererab i dop. M: RAEN; 2012. 528 s. [Russian]
2. Näsman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study. J Dent Res. 2013 Nov; 92(11): 1029-34. https://doi.org/10.1177/0022034513506443 PMid:24084670
3. Litovchenko VA, Garyachiy EV. Lechenie osteoporoticheskikh perelomov proksimalnogo otdela bedrennoy kosti u bolnykh pozhilogo i starcheskogo vozrasta [Treatment of osteoporotic fractures of the proximal femur in elderly and senile patients]. Mezhdunarod meditsinskiy zhurn. 2009; 2: 81-84. [Russian]
4. Hakim G, Volpin G. Surgical Treatment of Femoral Neck Fractures in Young Adults. Isr Med Assoc J. 2015; 17(6): 380-382.
5. Shurgaya MA. Sovremennye tendentsii povtornoy invalidnosti vsledstvie bolezney kostno-myshechnoy sistemy i soedinitelnoy tkani grazhdan pensionnogo vozrasta v Rossiyskoy Federatsii [Modern tendencies of repeated disability due to diseases of the musculoskeletal system and connective tissue of citizens of retirement age in the Russian Federation]. Mediko-sotsialnaya ekspertiza i reabilitatsiya. 2016; 19(2): 89-95. [Russian] https://doi.org/10.18821/15609537-2016-19-2-89-95
6. Rechel B, Grundy E, Robine JM, Cylus J, Mackenbach JP, Knai C, et al. Ageing in the European Union. Lancet. 2013; 381(9874): 1312-1322. https://doi.org/10.1016/S0140-6736(12)62087-X
7. Prieto-Alhambra D, Reyes C, Sainz MS, González-Macías J, Delgado LG, Bouzón CA, et al. In-hospital care, complications, and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study. Archives of Osteoporosis. 2018; 13(1): 96. https://doi.org/10.1007/s11657-018-0515-8 PMid:30218380 PMCid:PMC6153683
8. Kalchenko AV, Babalyan VA, Khvisyuk AN, Gurbanova TS, Cherepov DV. Analiz operativnogo lecheniya lits pozhilogo i starcheskogo vozrasta s perelomami proksimalnogo otdela bedrennoy kosti metodom nakostnogo osteosinteza plastinoy [Analysis of the surgical treatment of elderly and senile persons with fractures of the proximal femur by the method of external osteosynthesis with a plate]. Travma. 2017; 18(3): 80-85. [Russian] https://doi.org/10.22141/1608-1706.3.18.2017.105365
9. Kalchenko AV. Nash dosvid zastosuvannya odnopolyusnogo endoprotezuvannya pry perelomakh proksymalnogo viddilu stegnovoyi kistky v osib pokhylogo ta starechogo viku [Analysis of the surgical treatment of elderly and senile persons with fractures of the proximal femur by the method of external osteosynthesis with a plate]. Travma. 2019; 20(3): 42-48. [Ukrainian]. https://doi.org/10.22141/1608-1706.3.20.2019.172092
10. Shishkin SV, Sheyman IM, Abdin AA, Boyarskiy SG, Sazhina SV. Rossiyskoe zdravookhranenie v novykh ekonomicheskikh usloviyakh: vyzovy i perspektivy [Russian healthcare in the new economic conditions: challenges and prospects]. M: Vysshaya shkola ekonomiki; 2017. 85 s. [Russian]
11. Madridskiy mezhdunarodnyy plan deystviy po problemam stareniya 2002 goda [Madrid International Plan of Action on Aging 2002]. Doklad vtoroy Vsemirnoy assamblei po problemam stareniya. NY: OON; 2002. 8 s. [Russian]
12. Inacio MC, Weiss JM, Miric A, Hunt JJ, Zohman GL, Paxton EW. A community-based hip fracture registry: population, methods, and outcomes. Perm J. 2015; 19: 29-36. https://doi.org/10.7812/TPP/14-231 PMid:26057682 PMCid:PMC4500478
13. Zagorodniy NV, Volna AA, Panfilov II. Klinicheskoe vedenie patsientov starshe 75 let s perelomami proksimalnogo otdela bedrennoy kosti [Clinical management of patients over 75 years of age with fractures of the proximal femur]. Ros osteopat zhurn. 2016; 3-4 (30-38): 36-44. [Russian] https://doi.org/10.32885/2220-0975-2016-3-4-30-38
14. Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, et al. Osteoporosis: burden, health care provision and opportunities in the EU A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2011; 6: 59-155. doi: 10.1007/ s11657-011-0060-1 https://doi.org/10.1007/s11657-011-0060-1 PMid:22886101
15. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ. Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury. 2008; 39(10): 1157-1163. https://doi.org/10.1016/j.injury.2008.03.022 PMid:18653186
16. Grigorev IV. Perelomy proksimalnogo otdela bedrennoy kosti u pozhilykh lyudey: travmatologicheskie i sudebno-meditsinskie aspekty [Fractures of the proximal femur in the elderly: traumatological and forensic aspects]. Molodezhnyy nauchnyy forum: Estestvennye i meditsinskie nauki. Elektronnyy sbornik statey po materialam KhKhKhI studencheskoy mezhdunarodnoy zaochnoy nauch-prak konf. M: MTsNO; 2016. 2016; 2(30): 4-9. [Russian] URL: http://www.nauchforum.ru/archive/MNF_nature/2(30).pdf)
17. Belinov N, Davydov S. Metalloosteosintez sheyki bedrennoy kosti u patsientov s polipatiey [Metal osteosynthesis of the femoral neck in patients with polypathy]. Vrach. 2014; 10: 83-85. [Russian]
18. Akhtyamov IF, Kovalenko AN, Shigaev ES, Moiseev MYu, Khakimov MR, Gatina EB. Sovremennye khirurgicheskie metody lecheniya postradavshikh s perelomami proksimalnogo otdela bedrennoy kosti [Modern surgical methods of treating victims with fractures of the proximal femur]. Kazanskiy meditsinskiy zhurn. 2012; 2: 245-249. [Russian] https://doi.org/10.17816/KMJ2300