Baseline and pre-operative 1-year mortality risk factors in a cohort of 509 hip fracture patients consecutively admitted to a co-managed orthogeriatric unit (FONDA Cohort)

Menéndez-Colino, Rocío; Alarcón, T.; Gotor, P.; Queipo, Rocío; Ramírez-Martín, Raquel; Otero, Ángel; González-Montalvo, Juan Ignacio

doi:10.1016/j.injury.2018.01.003

Cited by 58 publications

(39 citation statements)

References 35 publications

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“…Since our current study also revealed that history of geriatric medical conditions like gastrointestinal and renal diseases substantially increased the risks of one-year mortality, and also shown by our previous report that only 3.5% of hip-fracture patients received geri-orthopedic co-management [ 9 ]. Furthermore, decreased muscle strength and vitamin D deficiency in geriatric hip fracture patients were also reported to increase mortality rates in the Spanish FONDA cohort [ 22 ]. Therefore, a multi-disciplinary management approach [ 23 , 24 ] (by orthopedic surgeons, geriatricians, and fracture liaison nurses) is strongly advised to patients identified with these risks factors (in particular, pre-fracture mobility and previous medical conditions) in order to proactively work towards improving the survival rate after an intracapsular hip fracture event.…”

Section: Discussionmentioning

confidence: 99%

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

et al. 2018

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BackgroundThe purpose of this registry-based retrospective study was to investigate the risk factors related to one-year mortality in displaced intracapsular fragility hip fracture patients.MethodsPatients were screened from the Fragility Fracture Registry. Inclusion criterion was displaced intracapsular hip fracture patients with atypical or pathological fractures excluded. One-year mortality was investigated against risk factors including age, gender, past medical history, pre-fracture mobility (PFM), pre-operation ASA grade, delayed surgery over 48 h, post-surgical complications, and length of stay at acute orthopedic ward (LOS).ResultsA total of 1050 patients were included for further analysis. Gross one-year mortality was 14.9%. One-year mortality was significantly higher in patients who received non-operative treatment and those who received surgery but delayed over 48 h after admission (both p < 0.001). Male gender (OR = 2.708), advanced age (OR = 1.359), higher risk ASA grades (III to V) (OR = 1.990), past history of gastrointestinal disease (OR = 1.671), and renal impairment (OR = 1.984) were related to higher one-year mortality. The mortality of patients in PFM grade 3 and LOS group 3 was significantly higher (OR = 2.240 and 1.722, respectively).ConclusionsHigher age, male gender, past gastrointestinal disease and renal impairment, ASA grade over 3, indoor confined pre-fracture ambulatory, and stay at hospital over 15 days were risk factors related to higher one-year mortality in surgically treated displaced intracapsular hip fracture patients. A multi-disciplinary approach is advised to patients identified with these risks factors and co-managed by orthopedic surgeons, geriatricians, and fracture liaison nurses.

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Section: Discussionmentioning

confidence: 99%

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

et al. 2018

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“…A hip fracture is associated with considerable socioeconomic costs [1] and constitutes a high-risk situation for an elderly patient, as the mortality for patients older than 65 years is 12-35% within the first year after the fracture [2] and remains elevated for several years [3].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of medication-related falls in 200 consecutive elderly patients with hip fractures: a cross-sectional study

et al. 2020

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Background: Hip fractures constitute a major health problem in elderly people and are often fall-related. Several factors can contribute to a fall episode leading to hip fracture, including fall-risk-increasing drugs (FRIDs), which are often used by elderly people. We aimed to investigate the prevalence of medication-related falls and to assess the role of FRIDs and potentially inappropriate medications (PIMs) in a population of elderly patients hospitalized for a hip fracture. Methods: We reviewed the patient records of 200 consecutive patients, aged ≥65 years, who were admitted for a hip fracture and evaluated whether medications were likely to have contributed to the fall episode. PIMs were identified using the Screening Tool of Older Persons' Prescriptions version 2 (STOPP) and by evaluating indications, contra-indications and interactions of the prescribed medications for each patient. Results: FRIDs were used by 175 patients (87.5%). Medications were considered a likely contributor to the fall in 82 patients (41%). These were most often psychotropic medications alone or in combination with antihypertensives and/or diuretics. The 82 patients with suspected medication-related falls used more medications, FRIDs and PIMs than the rest of the patients, and in 74 (90%) of the 82 patients, at least one medication considered to be a contributor to the fall was also a PIM. Conclusions: The prevalence of suspected medication-related falls was 41%. It seems likely that a medication review could have reduced, though not eliminated, the risk of falling in this group of patients.

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“…Hip fractures in the elderly were common and associated with considerable mortality [1,2] . While many researchers [6,8,9,10] had studied mortality after hip fracture, some studies [8,9,10] had certain weaknesses such as a short follow-up covering mainly in-hospital mortality up to 1 year after hip fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Hip fractures is a major source of morbidity and mortality, with mortality rates of up to 20-30% [1,2] in the rst post-operative year and nearly half of the patients do not regain their previous levels of function [3] . 1.6 million patients suffer from hip fracture every year worldwide, and this number is expected to increase to 6.3 million by 2050 [4] .…”

Section: Introductionmentioning

confidence: 99%

Cause of Death and Factors Associated With 5-Year Mortality After Hip Fracture Surgery

Wang

Zhao

Zheng

et al. 2020

Preprint

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Aim: the aims of this study were to identify the 5-year mortality rate after hip fracture, identify factors associated with this mortality, and identify the cause of death in these patients.Materials and Methods: A retrospective cohort study of geriatric patients (≥60 years of age) undergoing a hip fracture surgical procedure admitted to our institution between the 1 January 2012 and 31 December 2016 was performed. Demographic and clinical characteristics were collected. Patients or their careers were contacted by telephone or outpatient to ascertain their vital status, and cause of death if they had died at 5-year post-surgery. According to whether they were alive or death at 5-year post-surgery, patients were divided into survivor or non-survivor group. All variables including demographic data and clinical characteristics were compared for both survivors and non-survivors. Cox proportional hazards were used to determine independent risk factors for 5-year mortality. All cause of 5-year mortality in hip fracture were recorded.Result: A total of 327 patients with a median age of 80.00 years were included. 5-year mortality was 40.1%, and the death peak was concentrated during 6 months after surgery. The final multivariate model included 4 independent mortality risk factors: advanced age, stroke, albumin, delayed surgery, with an HR (95% confidence interval) 1.052(1.025-1.080), 1.612(1.104-2.353), 0.940(0.900-0.982), 1.638(1.072-2.498), respectively. Pulmonary infection, and cardiovascular disease were the most common cause of 5-year death.Conclusion: Our results showed that 5-year mortality was 40.1%. Advanced age, stroke, low albumin, and delayed surgery were associated with 5-year mortality after hip fracture surgery. Pulmonary infection, and cardiovascular disease were the most common cause of death.

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Baseline and pre-operative 1-year mortality risk factors in a cohort of 509 hip fracture patients consecutively admitted to a co-managed orthogeriatric unit (FONDA Cohort)

Cited by 58 publications

References 35 publications

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

One-year mortality in displaced intracapsular hip fractures and associated risk: a report of Chinese-based fragility fracture registry

Prevalence of medication-related falls in 200 consecutive elderly patients with hip fractures: a cross-sectional study

Cause of Death and Factors Associated With 5-Year Mortality After Hip Fracture Surgery

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