Functional autonomy and 12-month mortality in older adults with proximal femoral fractures in an orthogeriatric setting: risk factors and gender differences

Ceolin, Chiara; Bano, Gabriele; Biz, Carlo; Dianin, Marta; Bedogni, Marco; Guarnaccia, Aurelio; Berizzi, Antonio; Ruggieri, Pietro; Coin, Alessandra; Sergi, Giuseppe

doi:10.1007/s40520-023-02378-y

Cited by 10 publications

(3 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the study of 60,111 U.S. long-term nursing home residents, function declined substantially after fracture across all ADL domains assessed, including transferring, mobility in bed, personal hygiene and toileting and increasing baseline ADL dependence were all associated with decreased survival after hip fracture [22]. Ceolin's study also suggested that functional loss in older adults hospitalised for proximal femur fractures was greatest in the rst 6 months after discharge, and this increased the risk of death at 1 year [23].…”

Section: Discussionmentioning

confidence: 95%

The combined effect of controlling nutritional status increase and activities of daily living impairment on 12-month mortality of older adults after hip fracture: a retrospective cohort study

Chen,

Guo,

Tong

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective We aimed to explore the combined effect of nutritional status and functional autonomy was associated with all-cause mortality of older adults with hip fracture patients in the first year after hospitalization. Methods This is a single-center retrospective cohort study in older adults with hip fracture patients. Clinical data and laboratory results were collected from electronic medical record system of our hospital (2014–2021). The endpoint of this study was all-cause mortality in the first year after hospitalization. Results A total of 303 older adults were enrolled and all-cause mortality was 21.8%. Compared with patients who were alive at 1 year, those who died were older, had less body mass index (BMI), activities of daily living (ADL), hemoglobin, lymphocytes, total protein, albumin, triglycerides and total cholesterol. They also had higher age, C-reactive protein (CRP) and Controlling nutritional status (CONUT) score. Multivariable Cox analysis showed that BMI, ADL and CONUT were independent risk factors for all-cause mortality of hip fracture in elderly (HR (95% CI):2.808(1.638, 4.814), P < 0.001; 2.862(1.637, 5.003), P < 0.001; 2.322(1.236, 4.359), P = 0.009, respectively). More importantly, the combined index of CONUT and ADL had the best predictive performance based on ROC curve (AUC 0.785, 95% CI: 0.734–0.830, P < 0.0001). Kaplan-Meier survival curves for all-cause mortality showed that patients with CONUT increase and ADL impairment had a higher mortality rate at 1 year compared to CONUT decrease and ADL well (Log Rank χ2 = 45.717, P < 0.0001). Conclusions Combined index of CONUT increase and ADL impairment has good clinical value in assessing 1-year postoperative prognosis in older adults after hip fracture.

show abstract

Section: Discussionmentioning

confidence: 95%

The combined effect of controlling nutritional status increase and activities of daily living impairment on 12-month mortality of older adults after hip fracture: a retrospective cohort study

Chen,

Guo,

Tong

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In the study of 60,111 U.S. long-term nursing home residents, function declined substantially after fracture across all ADL score domains assessed, including transferring, mobility in bed, personal hygiene and toileting and increasing baseline ADL score dependence were all associated with decreased survival after hip fracture [ 34 ]. Ceolin’s study also suggested that functional loss in older adults hospitalised for proximal femur fractures was greatest in the first 6 months after discharge, and this increased the risk of death at 1 year [ 35 ]. However, malnutrition is related to losing walking independence (LWI) after hip fracture surgery.…”

Section: Discussionmentioning

confidence: 99%

Combined nutritional status and activities of daily living disability is associated with one-year mortality after hip fracture surgery for geriatric patients: a retrospective cohort study

Chen,

Guo,

Tong

et al. 2024

Aging Clin Exp Res

View full text Add to dashboard Cite

Objective We aimed to explore the association combined nutritional status and activities of daily living disability with all-cause mortality of older adults with hip fracture in the first year after hospitalization. Methods This is a single-center retrospective cohort study in older adults with hip fracture patients. Clinical data and laboratory results were collected from electronic medical record system of our hospital (2014–2021). The endpoint of this study was all-cause mortality in the first year after hospitalization. Results A total of 303 older adults were enrolled and all-cause mortality was 21.8%. The study population was categorized by CONUT score. Patients in CONUT score 5–12 had a higher age, ASA status, CRP and creatinine level, more patients with history of fracture, pneumonia and delirium, meanwhile, lower BMI and ADL score, lower hemoglobin, lymphocyte, total protein, albumin, triglyceride, total cholesterol and one year survival than those in CONUT score 0–4 (all P < 0.05). Multivariable Cox analysis showed that BMI, ADL score and CONUT score were independent risk factors for all-cause mortality of hip fracture in older adults (HR (95% CI):2.808(1.638, 4.814), P < 0.001; 2.862(1.637, 5.003), P < 0.001; 2.322(1.236, 4.359), P = 0.009, respectively). More importantly, the combined index of CONUT and ADL score had the best predictive performance based on ROC curve (AUC 0.785, 95% CI: 0.734–0.830, P < 0.0001). Kaplan-Meier survival curves for all-cause mortality showed that patients with CONUT score increase and ADL score impairment had a higher mortality rate at 1 year compared to CONUT score decrease and ADL score well (Log Rank χ2 = 45.717, P < 0.0001). Conclusions Combined CONUT and ADL score is associated with one-year mortality after hip fracture surgery for geriatric patients.

show abstract

“…However, the incidence rate has declined over the years among the Swedish population. Patients with hip fractures are vulnerable to increasing comorbidity with a high mortality risk, disability, and pain ( Bano et al, 2020 ; Ceolin et al, 2023 ; Elsevier & Cannada, 2020 ; Meyer et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The Femoral Nerve Block Setting the Agenda for Nursing Care of Older Patients With hip Fractures—A Qualitative Study

Unneby

2023

SAGE Open Nursing

View full text Add to dashboard Cite

Introduction Hip fractures among older people are common worldwide, and it is often associated with preoperative pain. Due to increased comorbidity and high age, traditional pain relief can be a challenge. An alternative to traditional pain relief is a femoral nerve block, which is safe and suitable for anesthesia and analgesia for hip fractures among patients with or without dementia. It is essential to provide adequate pain management, and nurses report negative attitudes toward opioids and seem to prefer alternative pain management. To our knowledge, no study has focused on staff's experiences of nursing care for patients treated with femoral nerve block. Aim To describe staff's experiences providing nursing care in preoperative pain and pain management to older patients with a hip fracture who received a femoral nerve block. Design A qualitative exploratory design. Method Semistructured interviews with 19 nurses or assistant nurses in an orthopedic ward or emergency department. They were experienced in caring for patients with hip fractures who received treatment with a femoral nerve block. The interviews were subjected to qualitative content analysis. Results Staff described the femoral nerve block as setting the agenda when caring for older patients with hip fractures in the preoperative phase. The outcome of the femoral nerve block affected nursing care, depending on if the femoral nerve block was successful or not. Nursing care requires timing, with a need for staff orienting to time and customizing their communication. Further, staff faced ethical challenges regarding doing good and not harm, relieving pain, and avoiding side effects. Conclusions The femoral nerve block was an important issue for nursing staff in patients with hip fractures in the preoperative phase. Our results point toward the benefits of giving femoral nerve blocks as soon as possible to facilitate nursing care, however, this should be studied in future research.

show abstract

Functional autonomy and 12-month mortality in older adults with proximal femoral fractures in an orthogeriatric setting: risk factors and gender differences

Cited by 10 publications

References 42 publications

The combined effect of controlling nutritional status increase and activities of daily living impairment on 12-month mortality of older adults after hip fracture: a retrospective cohort study

The combined effect of controlling nutritional status increase and activities of daily living impairment on 12-month mortality of older adults after hip fracture: a retrospective cohort study

Combined nutritional status and activities of daily living disability is associated with one-year mortality after hip fracture surgery for geriatric patients: a retrospective cohort study

The Femoral Nerve Block Setting the Agenda for Nursing Care of Older Patients With hip Fractures—A Qualitative Study

Contact Info

Product

Resources

About