Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis

Cui, Zhiyong; Feng, Hui; Meng, Xiangyu; Zhuang, Siying; Liu, Zhaorui; Yang, Kaifeng; Sun, Chuiguo; Xing, Yue; Zhou, Fang; Tian, Yun

doi:10.1007/s11657-019-0604-3

Cited by 42 publications

(39 citation statements)

References 46 publications

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“…The higher mortality in extracapsular hip fractures has been inconsistently reported. 18 This is similar to our results, where the type of fracture did not reach statistical significance in the multivariate exponential regression.…”

Section: Discussionsupporting

confidence: 92%

“…Other factors that are related to 1-year mortality after a hip fracture are serum albuminaemia, socioeconomic status, and the type of fracture. [17][18][19] Given the constant high risk of mortality after one year found in this study, these factors may also affect the long-term outcome.…”

Section: Discussionmentioning

confidence: 89%

“…21 We report a 1-year mortality rate of 0.16 (0.13-0.18), through the 17 years included in the study, which is within the lower limit of mortality at 1-year reported in the international literature. 7,18,22,23…”

Section: Discussionmentioning

confidence: 99%

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Survival analysis after hip fracture: higher mortality than the general population and delayed surgery increases the risk at any time

et al. 2020

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Purpose: To estimate survival curves in patients with hip fracture according to gender, age, type of fracture, and waiting time for surgery and to compare them with the life expectancy of the general population. The study hypothesis is that survival after hip fractures is significantly lower than in the general population, especially in cases that underwent delayed surgery, regardless of age and gender. Methods: A survival analysis study was designed and approved by our institutional ethics review board. All patients who were coded with a diagnosis of hip fracture from 2002 to 2018 were included in the study. A total of 1176 patients were included, and the median age was 81 years (18–105 years). Kaplan-Meier curves and log-rank tests were performed to compare survival curves between those who underwent surgery on time and those with surgical delays. An exponential multivariate regression model was estimated, and a hazard ratio (HR) was reported for age, gender, and wait time for surgery. A significance of 5% was used, and a confidence interval level of 95% was reported. Results: The Kaplan-Meier curves for delayed surgery (log-rank, p = 0.00) and the age group (log-rank, p = 0.00) were significantly different. Exponential regression estimated an HR 1.05 (1.05–1.07) for age, HR 1.80 (1.51–2.13) for men, and HR 1.93 (1.61–2.31) for each day of wait for surgery. Conclusions: The 2 significant findings of this study are that hip fracture patients over 40 years old have a higher risk of dying at any time compared to the general population and that the waiting time for surgery (a modifiable factor) decreases survival rates at any time.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

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Survival analysis after hip fracture: higher mortality than the general population and delayed surgery increases the risk at any time

et al. 2020

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“…For patients with hip fractures, the estimated 1-and 2-year morality rates in South Korea were reported to be 16% and 28%, respectively, and the prevalence of osteoporotic fractures as well as the associated societal costs are estimated to increase markedly given that the aging index is expected to increase up to 213.8% by 2030 [36]. In mainland China, the pooled estimate for the 1-year mortality rate following hip fracture was 13.96% between the years 2000 and 2018 [37]. Also, vertebral fractures occurred with a high prevalence in the very elderly population, with an estimated incidence of 30.4% according to the vertebral fracture assessment [38].…”

Section: Discussionmentioning

confidence: 99%

Bisphosphonates for Secondary Prevention of Osteoporotic Fractures: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Shi

Min

Wang

et al. 2019

BioMed Research International

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Purpose To investigate the comparative efficacies of the five most commonly used bisphosphonates for the secondary prevention of osteoporotic fractures in a Bayesian network meta-analysis. Methods Five databases and the reference lists of all acquired articles from inception to July 2017 were searched. A Bayesian random-effects model was employed, and vertebral, hip and nonvertebral nonhip fractures were assessed by odds ratios (ORs) and 95%credible intervals. Furthermore, with respect to each endpoint, rank probabilities for each bisphosphonate were evaluated using the surface under the cumulative ranking curve (SUCRA) value. Results Thirteen eligible studies were identified involving 11,822 patients with osteoporotic fractures. Overall in the pairwise meta-analyses, bisphosphonate use significantly reduced the risk of new vertebral, hip, and nonvertebral nonhip fractures, with ORs and 95% confidence intervals of 0.56 (0.49–0.64), 0.69 (0.48–0.98), and 0.82 (0.70–0.97), respectively. In network meta-analyses, significant differences were found between placebo and any one of the five bisphosphonates for new vertebral fractures. The rank probability plot and the SUCRA calculation results suggested that alendronate was the best intervention (14.6%) for secondary prevention of vertebral fractures, followed by zoledronate (15.3%) and etidronate (22.1%). In terms of the incidence of new hip fractures, alendronate was associated with the lowest incidence (18.5%), followed by zoledronate (43.1%) and risedronate (52.5%). However, zoledronate ranked lowest (16.6%) regarding the incidence of new nonvertebral nonhip fractures, followed by risedronate (23.8%) and alendronate (44.1%). Conclusions Bisphosphonates show significant efficacy for secondary prevention of new vertebral fractures, and alendronate is most likely to be successful at secondary prevention of vertebral and hip fractures compared with the other four bisphosphonates.

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“…Due to the high morbidity and mortality, hip fracture has become a major public health issue worldwide. A recent meta-analysis showed that the one year mortality rate was 13.96% after hip fracture in mainland China [ 1 ], and hip fracture was associated with excess short- and long-term all-cause mortality in Europe and USA [ 2 ]. At the same time, hip fracture incidence data suggested that hip fracture rates may be increasing in Poland [ 3 ], France [ 4 ], Japan [ 5 ], Italy [ 6 ], and China [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

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Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis

Cited by 42 publications

References 46 publications

Survival analysis after hip fracture: higher mortality than the general population and delayed surgery increases the risk at any time

Survival analysis after hip fracture: higher mortality than the general population and delayed surgery increases the risk at any time

Bisphosphonates for Secondary Prevention of Osteoporotic Fractures: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

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