Abstract
Background Neck of femur (NOF) fractures are a major cause of morbidity and mortality in the elderly, with incidence rising due to the aging population. The presence of comorbidities in elderly patients can increase the risk of complications and extend recovery time. Understanding how these health conditions influence recovery is crucial for improving patient outcomes. The high mortality rates and functional decline linked to NOF fractures emphasize the need for tailored treatment strategies. Objective To examine how comorbidities affect the prevalence, recovery outcomes, and overall prognosis of neck of femur fractures in elderly trauma patients. Materials and methods A retrospective cohort study was conducted at the Orthopedic Department of Mardan Medical Complex, Pakistan, between December 2023 and March 2025. The study focused on elderly patients (aged ≥65 years) diagnosed with neck of femur (NOF) fractures. Data were extracted from patient medical records, including demographic information, comorbidities, medical history, and recovery outcomes. Statistical analyses, such as descriptive statistics, chi-square tests, and correlation analyses, were performed to investigate the relationships between comorbidities and all studied variables. Additionally, data visualizations, including boxplots, barplots, and heatmaps, were utilized to further explore the associations between comorbidities and all studied variables. Results The study population consisted of 163 patients, with 70.55% males (115 patients) and 29.45% females (48 patients). The mean age was 80.23 ± 9.02 years. Anemia had the highest prevalence, affecting 71.77% (117 patients), followed by hypertension in 60.12% (98 patients), diabetes in 57.05% (93 patients), and cardiovascular disease in 55.21% (90 patients). Postoperative complications were common, with hyperglycemia (31.90%, 52 patients), deep vein thrombosis (18.40%, 30 patients), and heart failure (12.88%, 21 patients) being the most frequent. Comorbidities such as anemia, diabetes, and cardiovascular diseases were strongly associated with longer hospital stays, delayed surgery, extended rehabilitation periods, and reduced follow-up care compliance. Additionally, a significant correlation was found between the number of comorbidities and higher pain levels, particularly in patients with anemia and diabetes. Conclusion Comorbidities notably impair recovery in elderly patients with NOF fractures, with anemia, hypertension, diabetes, and cardiovascular diseases contributing to delayed recovery, complications, and higher healthcare costs. Early intervention, personalized treatment plans, and targeted rehabilitation are crucial to improve outcomes. This study highlights the importance of thorough preoperative assessments and ongoing management of chronic conditions in this patient population.