NCOG-65. MR-GUIDED LASER INTERSTITIAL THERMAL THERAPY FOR BRAIN TUMORS IN GERIATRIC PATIENTS

Abstract INTRODUCTION There is a paucity of studies assessing the use of magnetic resonance-guided laser interstitial thermal therapy (LITT) in the elderly population. METHODS Geriatric patients (≥65 years) treated with LITT for intracranial tumors at a single institution from January 2011 to November 2019 were retrospectively identified. We grouped patients into two cohorts: 65-74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded. RESULTS There were 55 patients who underwent 64 distinct LITT procedures. The majority of tumors (62.5%) treated were recurrent brain metastasis/radiation necrosis. The median hospital length of stay was 1 day, with no significant difference between age groups. Hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (68.3%) were discharged to their preoperative accommodation. Rate of discharge to home was not significantly different between age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1%) were found to have acute neurological complications, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (n = 1). The complication and 30-day postoperative mortality rate were not significantly different between age groups. CONCLUSIONS LITT can be considered as a minimally invasive and safe neurosurgical procedure for treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential as neurosurgeons treat an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT.

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Magnetic resonance–guided laser interstitial thermal therapy for brain tumors in geriatric patients

Neurosurgical FOCUS ◽

10.3171/2020.7.focus20462 ◽

2020 ◽

Vol 49 (4) ◽

pp. E12

Author(s):

Elizabeth E. Ginalis ◽

Shabbar F. Danish

Keyword(s):

Brain Tumors ◽

Neurological Symptom ◽

Geriatric Patients ◽

Age Groups ◽

Postoperative Mortality ◽

Thermal Therapy ◽

Intracranial Tumors ◽

Laser Interstitial Thermal Therapy ◽

Group 2 ◽

Group 1

OBJECTIVEThere is a paucity of studies assessing the use of MR-guided laser interstitial thermal therapy (LITT), specifically in the elderly population. The aim of this study was to evaluate the safety of LITT for brain tumors in geriatric patients.METHODSGeriatric patients (≥ 65 years of age) treated with LITT for intracranial tumors at a single institution between January 2011 and November 2019 were retrospectively identified. The authors grouped patients into two distinct age cohorts: 65–74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded for each patient.RESULTSFifty-five geriatric patients underwent 64 distinct LITT procedures for brain tumors. The majority of lesions (40 [62.5%]) treated were recurrent brain metastases or radiation necrosis. The median modified frailty index was 0.1 (low frailty; range 0–0.4) for patients in group 1 and 0.2 (intermediate frailty; range 0–0.4) for patients in group 2 (p > 0.05). The median hospital length of stay (LOS) was 1 day (IQR 1–2 days); there was no significant difference in LOS between the age groups. The hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (43 [68.3%] of 63 cases) were fit for discharge to their preoperative accommodation following LITT. The rate of discharge to home was not significantly different between the age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1% of cases) were found to have acute neurological complications following LITT, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (1 case). The complication and 30-day postoperative mortality rates were not significantly different between the two age groups.CONCLUSIONSLITT can be considered a minimally invasive and safe neurosurgical procedure for the treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential, because neurosurgeons are treating an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT without considering frailty and comorbidities.

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SURG-06. LASER INTERSTITIAL THERMAL THERAPY COMPARED TO CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.141 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i31-i32

Author(s):

Christopher Hong ◽

Di Deng ◽

Nanthiya Sujijantarat ◽

Alberto Vera ◽

Veronica Chiang

Keyword(s):

Brain Metastases ◽

Radiation Necrosis ◽

Symptom Relief ◽

Group Analysis ◽

Progression Free Survival ◽

Thermal Therapy ◽

Recurrent Tumor ◽

Laser Interstitial Thermal Therapy ◽

Neurological Outcomes ◽

Significant Difference

Abstract Many publications report laser-interstitial thermal therapy (LITT) as a viable alternative treatment to craniotomy for radiation necrosis (RN) and re-growing tumor occurring after stereotactic radiosurgery (SRS) for brain metastases. No studies to-date have compared the two options. The aim of this study was to retrospectively compare outcomes after LITT versus craniotomy for regrowing lesions in patients previously treated with SRS for brain metastases. Data were collected from a single-institution chart review of patients treated with LITT or craniotomy for previously irradiated brain metastasis. Of 75 patients, 42 had recurrent tumor (56%) and 33 (44%) had RN. Of patients with tumor, 26 underwent craniotomy and 16 LITT. For RN, 15 had craniotomy and 18 LITT. There was no significant difference between LITT and craniotomy in ability to taper off steroids or neurological outcomes. Progression-free survival (PFS) and overall survival (OS) were similar for LITT versus craniotomy, respectively: %PFS-survival at 1-year = 72.2% versus 61.1%, %PFS-survival at 2-years = 60.0% versus 61.1%, p = 0.72; %OS-survival at 1-year = 69.0% versus 69.3%, %OS-survival at 2-years = 56.6% versus 49.5%, p = 0.90. This finding persisted on sub-analysis of smaller lesions under < 3cm in diameter. Craniotomy resulted in higher rates of pre-operative deficit improvement than LITT (p < 0.01). On sub-group analysis, the single factor most significantly associated with OS and PFS was pathology of the lesion. About 40% of tumor lesions needed post-operative salvage with radiation after both craniotomy and LITT. LITT was as efficacious as craniotomy in achieving local control of recurrent irradiated brain metastases and facilitating steroid taper, regardless of pathology. Craniotomy appears to be more advantageous for providing symptom relief in those with pre-operative symptoms.

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SURG-07. Plasmonic gold nanostars to increase the efficiency and specificity of laser interstitial thermal therapy (LITT) in the treatment of brain tumors

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab071.100 ◽

2021 ◽

Vol 3 (Supplement_3) ◽

pp. iii24-iii25

Author(s):

Ethan Srinivasan ◽

Pakawat Chongsathidkiet ◽

Ren Odion ◽

Yang Liu ◽

Eric Sankey ◽

...

Keyword(s):

Ex Vivo ◽

Thermal Therapy ◽

Surrounding Tissue ◽

Intracranial Tumors ◽

Invasive Treatment ◽

Laser Interstitial Thermal Therapy ◽

Gold Nanostars ◽

Pet Ct ◽

The Impact

Abstract Introduction Laser interstitial thermal therapy (LITT) is an effective minimally-invasive treatment option for intracranial tumors. Our group produced plasmonics-active gold nanostars (GNS) designed to preferentially accumulate within intracranial tumors and amplify the ablative capacity of LITT while better conforming to tumor boundaries and protecting surrounding tissue. Materials and Methods: The 12nm GNS were synthesized using reduced HAuCl4 with Na3C6H5O7 seeds, mixed with AgNO3, C6H8O6, and HAuCL4, and coated with polyethylene glycol then functionalized with methoxy PEG thiol. CT-2A glioma cells were intracranially implanted into mice, followed 18 days later by IV injection of GNS. PET-CT was performed at 10-minutes, 24-, and 72-hours post-GNS administration, with autoradiography (AR) and histopathology (HP) on sacrifice after the last scan. To test the impact of GNS on LITT coverage capacity in appropriately sized ex vivo models, we utilized agarose gel-based phantoms incorporating control and GNS-infused central “tumors” in multiple shapes. LITT was administered with the NeuroBlate System. Results In vivo, GNS preferentially accumulated within intracranial tumors on PET-CT at the 24- and 72-hour timepoints. AR and HP confirmed high GNS accumulation within tumor. Ex vivo, in cuboid tumor phantoms, the GNS-infused phantom heated 5.5x faster than the control, rising 0.49°C per minute compared to 0.09°C. In a split-cylinder tumor phantom with half containing GNS, the GNS-infused border heated 2x faster and the surrounding area was exposed to 30% lower temperatures. In a GNS-infused star-shaped phantom, the heat spread contoured along phantom boundaries. Conclusion Our results provide evidence for use of GNS to improve the specificity, efficiency, and potentially safety of LITT. The in vivo data support selective accumulation within intracranial tumors, and the GNS-infused phantom experiments demonstrate increased rates of heating within the tumor model, heat contouring to tumor borders, and decreased heating of surrounding regions representing normal structures.

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SURG-29. LASER INTERSTITIAL THERMAL THERAPY COMPARED TO CRANIOTOMY FOR TREATMENT OF RECURRENT GLIOBLASTOMA

Neuro-Oncology ◽

10.1093/neuonc/noz175.1029 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi245-vi245

Author(s):

Ali Palejwala ◽

Kyle O’connor ◽

Chad Glenn ◽

Michael Sughrue

Keyword(s):

Overall Survival ◽

Adjuvant Therapy ◽

Perioperative Complications ◽

Progression Free Survival ◽

Senior Author ◽

Thermal Therapy ◽

Free Survival ◽

Laser Interstitial Thermal Therapy ◽

Significant Difference ◽

Recurrent Gbm

Abstract There have been publications that propose the use of laser interstitial thermal therapy (LITT) as a viable alternative to craniotomy for the treatment of glioblastoma (GBM). The aim of this study was to retrospectively compare outcomes after LITT versus craniotomy for patients with recurrent GBM. To adequately match the cohorts, we included only pre-treatment tumor volumes of under 15 cc. We retrospectively collected data on all patients presenting with recurrent GBM, with a recurrence volume under 15 cc. These patients were either treated with LITT or craniotomy by the senior author. Data included demographics, tumor location and volume, tumor markers, perioperative complications, re-initiation of adjuvant chemotherapy, and long-term follow up data. We performed 23 LITT treatments and 34 craniotomies for recurrent GBM in patients that met selection criteria. There was no significant difference in the patients’ age, tumor volume (6.38 for craniotomy versus 5.765 cc for LITT), location, and post-procedure KPS. Patients that underwent LITT had significantly reduced inpatient stays in comparison to craniotomy (1.7 versus 4.2 days). They also had less perioperative complications (13.0% versus 32.3% for craniotomy). It was found that 28 out of the 34 patients that underwent craniotomy were able to undergo adjuvant therapy; in comparison, 15 out of the 23 patients who underwent LITT had undergone adjuvant therapy. Of these patient’s that underwent adjuvant therapy, 87% of patients were able to receive bevacizumab or a clinical trial versus 42% after craniotomy. Progression-free survival (PFS) and overall survival (OS) after procedure were similar for LITT versus craniotomy, respectively: % PFS-survival at 6 months = 23.5% versus 21.7%. Overall survival did not significantly differ at 9 months versus 9.9 months respectively. LITT appears to be safe and may be as efficacious as craniotomy in achieving progression free survival for small to moderate volume recurrent GBM.

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Evaluation of Renal Function in Alzheimer’s Disease and Geriatric Patients: Results from a Turkish Two-Center Study

Journal of Medical Biochemistry ◽

10.1515/jomb-2016-0028 ◽

2017 ◽

Vol 36 (1) ◽

pp. 54-61

Author(s):

Zubeyde Erbayraktar ◽

Ahmet Turan Evlice ◽

Gokhan Yilmaz ◽

Canan Yazici ◽

Gorsev Yener ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Renal Function ◽

Total Protein ◽

Geriatric Patients ◽

Age Groups ◽

Conclusive Evidence ◽

University Hospitals ◽

Protein Levels ◽

Significant Difference

SummaryBackground:Alzheimer’s disease (AD) is a severe multifactorial neurodegenerative proteopathy associated with advanced age. Discrepancies in the renal function of these patients compared to geriatric patients with dementia have rarely been reported. In this study, we aimed to disclose the importance of associated renal changes for the pathogenesis of AD.Methods:Patients with AD (n=107) and geriatric patients with dementia and without dementia (n=124) (231 patients in total) from Dokuz Eylul and Cukurova University Hospitals were enrolled in the study. We measured serum Na, K, Cl, Ca, BUN, creatinine, total protein levels and MDRD [eGFR] in all groups.Results:From Izmir Center, the first study arm consisted of patients with AD dementia (n=74), and the second arm included geriatric patients with dementia (n=79). From Adana, 78 patients were recruited to the study, of which 33 were with AD and 45 were geriatric patients without dementia. When we analyzed comparatively the AD and geriatric dementia patients study arms, a statistically significant difference was observed both in the median age (p<0.001), as well as in the biochemical parameters from Izmir Center: Na (p<0.001), K (p<0.001), Cl (p<0.05), Ca (p<0.001), BUN (p<0.05), creatinine (p<0.001), total protein (p<0.001) and MDRD [eGFR] (p<0.001). However, these were not significantly different between AD and geriatric patients without dementia in the Adana group.Conclusions:Our results indicate that renal function is prone to alterations in different age groups of patients with AD. However, there is no conclusive evidence that renal function is one of the risk factors in AD.

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EXTH-19. INTEGRATION OF PLASMONIC GOLD NANOSTARS AND LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR SPECIFIC AND AMPLIFIED ABLATION OF BRAIN TUMORS

Neuro-Oncology ◽

10.1093/neuonc/noab196.658 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi167-vi167

Author(s):

Ethan Srinivasan ◽

Pakawat Chongsathidkiet ◽

Ren Odion ◽

Yang Liu ◽

Eric Sankey ◽

...

Keyword(s):

Ex Vivo ◽

Thermal Therapy ◽

Surrounding Tissue ◽

Intracranial Tumors ◽

Invasive Treatment ◽

Laser Interstitial Thermal Therapy ◽

Gold Nanostars ◽

Pet Ct ◽

The Impact

Abstract INTRODUCTION Laser interstitial thermal therapy (LITT) is an effective minimally-invasive treatment option for intracranial tumors. Our group produced plasmonics-active gold nanostars (GNS) designed to preferentially accumulate within intracranial tumors and amplify the ablative capacity of LITT while better conforming to tumor boundaries and protecting surrounding tissue. MATERIALS AND METHODS The 12nm GNS were synthesized using reduced HAuCl4 with Na3C6H5O7 seeds, mixed with AgNO3, C6H8O6, and HAuCL4, and coated with polyethylene glycol then functionalized with methoxy PEG thiol. CT-2A glioma cells were intracranially implanted into mice, followed 18 days later by IV injection of GNS. PET-CT was performed at 10-minutes, 24-, and 72-hours post-GNS administration, with autoradiography (AR) and histopathology (HP) on sacrifice after the last scan. To test the impact of GNS on LITT coverage capacity in appropriately sized ex vivo models, we utilized agarose gel-based phantoms incorporating control and GNS-infused central “tumors” in multiple shapes. LITT was administered with the NeuroBlate System. RESULTS In vivo, GNS preferentially accumulated within intracranial tumors on PET-CT at the 24- and 72-hour timepoints. AR and HP confirmed high GNS accumulation within tumor. Ex vivo, in cuboid tumor phantoms, the GNS-infused phantom heated 5.5x faster than the control, rising 0.49°C per minute compared to 0.09°C. In a split-cylinder tumor phantom with half containing GNS, the GNS-infused border heated 2x faster and the surrounding area was exposed to 30% lower temperatures. In a GNS-infused star-shaped phantom, the heat spread contoured along phantom boundaries. CONCLUSIONS Our results provide evidence for use of GNS to improve the specificity, efficiency, and potentially safety of LITT. The in vivo data support selective accumulation within intracranial tumors, and the GNS-infused phantom experiments demonstrate increased rates of heating within the tumor model, heat contouring to tumor borders, and decreased heating of surrounding regions representing normal structures.

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Stereotactic EEG-guided laser interstitial thermal therapy for mesial temporal lobe epilepsy

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-316833 ◽

2017 ◽

Vol 89 (5) ◽

pp. 542-548 ◽

Cited By ~ 23

Author(s):

James X Tao ◽

Shasha Wu ◽

Maureen Lacy ◽

Sandra Rose ◽

Naoum P Issa ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Mesial Temporal Lobe Epilepsy ◽

Thermal Therapy ◽

Temporal Lobectomy ◽

Laser Interstitial Thermal Therapy ◽

Selective Amygdalohippocampectomy ◽

Significant Difference ◽

Mesial Temporal Lobe ◽

Mri Guided

ObjectiveTo determine the outcomes of combined stereo-electroencephalography-guided and MRI-guided stereotactic laser interstitial thermal therapy (LITT) in the treatment of patients with drug-resistant mesial temporal lobe epilepsy (mTLE).MethodsWe prospectively assessed the surgical and neuropsychological outcomes in 21 patients with medically refractory mTLE who underwent LITT at the University of Chicago Medical Center. We further compared the surgical outcomes in patients with and without mesial temporal sclerosis (MTS).ResultsOf the 21 patients, 19 (90%) underwent Invasive EEG study and 11 (52%) achieved freedom from disabling seizures with a mean duration of postoperative follow-up of 24±11 months after LITT. Eight (73%) of 11 patients with MTS achieved freedom from disabling seizures, whereas 3 (30 %) of 10 patients without MTS achieved freedom from disabling seizures. Patients with MTS were significantly more likely to become seizure-free, as compared with those without MTS (P=0.002). There was no significant difference in total ablation volume and the percentage of the ablated amygdalohippocampal complex between seizure-free and non-seizure-free patients. Presurgical and postsurgical neuropsychological assessments were obtained in 10 of 21 patients. While there was no group decline in any neuropsychological assessment, a significant postoperative decline in verbal memory and confrontational naming was observed in individual patients.ConclusionsMRI-guided LITT is a safe and effective alternative to selective amygdalohippocampectomy and anterior temporal lobectomy for mTLE with MTS. Nevertheless, its efficacy in those without MTS seems modest. Large multicentre and prospective studies are warranted to further determine the efficacy and safety of LITT.

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A phase II study of laser interstitial thermal therapy combined with doxorubicin in patients with recurrent glioblastoma

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab164 ◽

2021 ◽

Author(s):

Omar H Butt ◽

Alice Y Zhou ◽

Jiayi Huang ◽

William A Leidig ◽

Alice E Silberstein ◽

...

Keyword(s):

Salvage Therapy ◽

Low Dose ◽

Cox Proportional Hazards ◽

Recurrent Glioblastoma ◽

Thermal Therapy ◽

Limiting Factor ◽

Laser Interstitial Thermal Therapy ◽

Local Progression ◽

Significant Difference ◽

Historical Controls

Abstract Background The blood brain barrier (BBB) is a major limiting factor for drug delivery in brain tumors. Laser interstitial thermal therapy (LITT) disrupts the peritumoral BBB. In this study, we examine survival in patients with recurrent glioblastoma (GBM) treated with LITT followed by low-dose doxorubicin, a potent anti-neoplastic drug with poor BBB permeability. Methods Forty-one patients with recurrent GBM were enrolled; thirty patients were evaluable. Participants underwent LITT followed by 6 weekly doxorubicin treatments starting within one week (Early Arm) or at 6-8 weeks (Late Arm) after LITT. The overall survival (OS), local progression-free survival (PFS), and any PFS were compared to historical controls treated with bevacizumab salvage therapy (n = 50) or LITT with standard BBB-permeable salvage therapy (n = 28). Cox proportional hazards models examined the contribution of age, gender, MGMT promoter status, and IDH-mutation status on any PFS and OS. Adverse events were also cataloged. Results The Late Arm and all patients (Early Arm + Late Arm) demonstrated significant improvement in OS compared to historical controls treated with bevacizumab (p < 0.001) and LITT with standard salvage therapy (p < 0.05). No significant difference in any PFS was observed between either arm and historical controls. Low-dose doxorubicin was well-tolerated with comparable adverse event rates between the arms. Conclusions Low-dose doxorubicin given after LITT is well tolerated and correlated with higher OS compared to historical controls treated with bevacizumab or LITT with standard salvage chemotherapy. A larger study is needed to further characterize survival and progression patterns.

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SURG-09. Benefits of laser interstitial thermal therapy in the treatment of biopsy-proven radiation necrosis

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab071.102 ◽

2021 ◽

Vol 3 (Supplement_3) ◽

pp. iii25-iii25

Author(s):

Emily Lerner ◽

Ethan Srinivasan ◽

Eric Sankey ◽

Matthew Grabowski ◽

Andrew Griffin ◽

...

Keyword(s):

Radiation Necrosis ◽

Thermal Therapy ◽

Definitive Treatment ◽

Study Endpoint ◽

Lesion Volume ◽

Variable Response ◽

Invasive Treatment ◽

Laser Interstitial Thermal Therapy ◽

Local Progression ◽

Significant Difference

Abstract Introduction Laser interstitial thermal therapy (LITT) is a minimally-invasive treatment option often used for patients with deep-seated intracranial lesions. It has been implemented as a definitive treatment for radiation necrosis (RN), which occurs in 9–14% of patients after stereotactic radiosurgery (SRS) for brain metastases (BM). Medical management (MM) with steroids is a common first-line therapy, with variable response and numerous side effects, especially regarding immunotherapy. Methods Patients with biopsy-proven RN after SRS for BM who received LITT or MM at two academic centers were retrospectively reviewed. Treatment failure was defined as radiographic progression that necessitated a change in management. Measurements of total (TLV) and contrast-enhancing lesion volume (ceLV) were obtained from MRI by semi-automated analysis using the BrainLab iPlan Cranial 3.0 software. Results Seventy-two patients were followed for 10.0 (4.2–25.1) months and 57 (79%) received LITT. Steroid cessation occurred at a median of 37 days post-LITT compared to 245 days after MM (p<0.01). On Kaplan-Meier analyses, there was no significant difference between the two groups in overall survival (LITT median of 15.2 months vs 11.6 months, p = 0.60) or freedom from local progression (13.6 months vs. 7.06 months), though LITT trended to show a benefit in both metrics. When controlled for follow-up duration, patients treated with LITT were three times more likely to be weaned off steroids prior to the study endpoint compared to those who were medically managed (p=0.003). The LITT cohort demonstrated a general radiographic trend of initially increased CeLV followed by contraction, with significant decreases from pre-operative at 10–12 months (p<0.01). The MM group did not demonstrate any statistically significant radiographic trends. Conclusion These results suggest that LITT for RN significantly reduces the time to steroid cessation and characterize a stereotyped radiographic response to LITT. Future prospective studies will be important to their validation.

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The impact of gender differences on mortality in elderly patients after hip fracture

Vojnosanitetski pregled ◽

10.2298/vsp161122022p ◽

2018 ◽

Vol 75 (9) ◽

pp. 918-925

Author(s):

Tanja Prodovic ◽

Branko Ristic ◽

Dusan Vucetic ◽

Dragana Ignjatovic-Ristic

Keyword(s):

Gender Differences ◽

Hip Fracture ◽

Mortality Rate ◽

Elderly Patients ◽

Risk Score ◽

Postoperative Mortality ◽

Significant Difference ◽

Male Patients ◽

The Impact ◽

Overall Risk

Background/Aim. Hip fracture is one of the leading causes of death in elderly population. We evaluated the impact of gender differences on mortality rate in elderly patients with hip fracture. Methods. The study included all hospitalized elderly patients (aged over 65 years) with hip fracture during 2013. The patients were classified into four risk groups in accordance with institutional ?i?li Etfal risk factor assessment scale ISERFAS to estimate postoperative mortality. Clinical, laboratory and risk score results were gender matched between survived and deceased patients. Hospital mortality was monitored as well as mortality at intervals of three and six months. The prediction effect of gender and overall risk variables on mortality rate were determined by univariate and multivariate logistic regression analyses. Results. The complete sample included 434 female and 163 male patients. Average age of men was 77.95 years and 79.18 years for women. Femoral neck fracture was more often seen in women (44.5%), but with no statistically significant difference (p = 0.57). Significant difference between the genders in relation to the risk score values was determined (p = 0.024). It was observed that the values of risk score was lower in the female patients and higher in the male patients. Cumulative mortality was 6% during hospital stay, 17.8% after three months and 25% after six months, respectively. In-hospital and six months after the hip fracture, the mortality rates were similar in both genders. The mortality rate was significantly higher in male patients (p = 0.035) three months after the hip fracture. The overall risk observed at all mortality intervals was a significant predictor by itself (p = 0.000). Independent gender prediction effect disappeared in joint effects of patients? overall risk. Conclusion. Gender can be defined as a significant mortality predictor in patients with hip fracture. A risk assessment system to estimate postoperative mortality for hip fractures would be helpful in planning treatment for each patient.

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