Predictors of Complications and One-Year Mortality in Adult Patients With Femoral Neck Fractures: A Retrospective Study

Introduction Femoral neck fractures (FNFs) are associated with significant morbidity and mortality, particularly in older adults. This study aimed to identify predictors of complications and mortality among patients with FNFs in a tertiary care center in Saudi Arabia. Methods A retrospective review was conducted of 183 patients admitted with FNFs between January 2016 and August 2024. Demographic, clinical, and surgical data were collected. Statistical analyses included descriptive summaries, univariate comparisons, and multivariate logistic regression to identify independent predictors of complications and mortality. Results The mean age was 71.8 ± 17.0 years, and 104 (56.8%) were female. Surgical treatment was performed in 171 (93.4%) patients, most commonly hemiarthroplasty 113 (61.7%). Complications occurred in 48 (26.2%) patients, while 13 (7.1%) patients died within one year. Patients with complications had significantly longer hospital stays (13.5 ± 12.8 vs. 9.6 ± 6.2 days, p = 0.007). Mortality was associated with the Garden classification (p = 0.011), chronic kidney disease (p = 0.039), conservative management (p = 0.013), and postoperative infection (p = 0.042). On multivariate analysis, the Garden classification independently predicted mortality (OR 3.09, 95% CI 1.10-8.67, p = 0.032). Conclusion Garden classification independently predicted mortality, while chronic kidney disease, postoperative infection, and conservative management were associated with mortality on univariate analysis. Complications significantly prolong hospitalization. To improve results, high-risk patients must be treated early, and perioperative care must be optimized.