OBJECTIVES : According to the literature, 12-month mortality rate of elderly patients after proximal femur fracture (PFF) is 30.1% in men and 19.5% in women, even if a well-organized patient routing system for surgical treatment is present. Currently, there are no special registries for PFF patients in Russia, studies show that only 37% of patients are hospitalized and 12.5% get surgical treatment (a “gold” standard of treatment). This study aims to estimate incidence of PFF and mortality from long-term PFF effects in patients aged 60 years and older in Russia given treatment methods distribution.

METHODS : Incidence and mortality was modeled based on the 2018 hospital bills data (inpatient admissions, outpatient services, patient routing), age and gender population structure, mortality rates for different treatment methods. For the first time, inpatient, emergency and outpatient data were sourced from the Compulsory Medical Insurance Fund. For comparison a systematic literature review was conducted to find PFF incidence and mortality in Russia and worldwide.

RESULTS : Incidence coefficients for sex and age groups estimated by the model were comparable with data from European population studies. The incidence rate of PPF in Russia was 751.21 cases per 100,000 population aged 60 years and older, of which 38.59% patients were hospitalized and 15.6% received surgical treatment. Estimated incidence is higher compared to Russian literature data (395.68 cases per 100,000). Mortality rates from the long-term effects of PFFs were calculated by sex and age and totaled to 346.4 cases per 100,000.

CONCLUSIONS : The modelling showed significant underestimation of published PFF incidence and 12-month mortality following PFF in Russia, whereas long-term effects stay uncaptured. Current patient routing systems for PFF and absence of national patient registries do not ensure adequate level of hospitalization and surgical treatment resulting in underestimated incidence and increased mortality.