Hip fracture and mortality: study of specific causes of death and risk factors

Barceló, Montserrat; Torres, Olga; Mascaró, Joan; Casademont, Jordi

doi:10.1007/s11657-020-00873-7

Cited by 46 publications

(58 citation statements)

References 26 publications

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“…Anyway, based on the association between muscle function and bone properties after stroke, osteoporosis is an important post-stroke complication ( Yang et al, 2020 ). Post-stroke predisposition to instability and osteoporosis increase the risk of hip fractures which increase mortality risk in both sexes but particularly in men ( Barcelo et al, 2021 ). Otherwise, females have much higher prevalence of osteoporosis in our as well as in other studies.…”

Section: Discussionmentioning

confidence: 99%

Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation

Kautzky‐Willer

Harreiter

Thomas

et al. 2021

Front. Aging Neurosci.

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Objective: Little is known about possible sex and gender differences in post-stroke neurorehabilitation outcomes. We aimed to analyze if functional performance, prevalence and impact of comorbidities at admission, and success of inpatient stroke-neurorehabilitation differ between men and women.Methods: Retrospective cohort analysis of 1,437 men and 907 women with prior cerebral infarction treated at a neurorehabilitation clinic between 2012 and 2017; multiple linear regression was used to examine the influence of sex/gender as well as multiple confounders on health and functional outcomes. The main outcome measures were Barthel index (BI) at admission and its change during 4 weeks inpatient neurorehabilitation.Results: Men had been diagnosed with osteoporosis less frequently than women but more often with type 2 diabetes mellitus, coronary artery or chronic kidney disease (p ≤ 0.01). Although twice as many women presented with pre-stroke depression compared to men, the risk of post-stroke depression detected during rehabilitation was comparable. Men were more likely to have less than 30 days between diagnosis and neurorehabilitation start than women (p < 0.03). At admission, women exhibited less autonomy, a lower BI, a higher pain score and worse 2-min walk test (2′WT) compared to men (p < 0.001). Among males osteoporosis and peripheral artery disease independently predicted BI at admission, in women it was pre-stroke depression, dementia, and arterial fibrillation. During neurorehabilitation, both sexes improved regarding BI, pain and walk tests (p < 0.001). Despite comparable rehabilitation effectiveness, women still had worse functional outcomes than males at discharge. Time after stroke to start of neurorehabilitation and length of the stay but, most strongly, the simple 2′WT at admission, and in women, pain intensity independently predicted post-stroke functional status and recovery.Conclusion: Women presented with worse functional status at admission to neurorehabilitation. Although men and women showed similar rehabilitation effectiveness, women still displayed worse clinical outcome measures and higher levels of pain at discharge. Early access and gender-sensitive, personalized post-stroke care with more focus on different comorbidities and psychosocial factors like pain levels and management, could further improve neurorehabilitation outcomes.

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Section: Discussionmentioning

confidence: 99%

Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation

Kautzky‐Willer

Harreiter

Thomas

et al. 2021

Front. Aging Neurosci.

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“…According to the Fisher's exact probability test, there was no significant difference between the two groups ( P = 0.595 > 0.05). Factors associated with mortality were age, gender, comorbidities, type of fracture, timing of surgery and rehabilitation, etc 31 . In addition, the sample size of this study was relatively small, and those patients with severe comorbidities were excluded, possibly leading to some bias in the results.…”

Section: Discussionmentioning

confidence: 99%

“…Factors associated with mortality were age, gender, comorbidities, type of fracture, timing of surgery and rehabilitation, etc. 31 In addition, the sample size of this study was relatively small, and those patients with severe comorbidities were excluded, possibly leading to some bias in the results. Therefore, further studies are needed to explore the effects of remote rehabilitation on postoperative mortality.…”

Section: Discussionmentioning

confidence: 99%

Effect of Home‐based Telerehabilitation on the Postoperative Rehabilitation Outcome of Hip Fracture in the Aging Population

Zhang

et al. 2022

Orthopaedic Surgery

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Objective To investigate the effects of home‐based telerehabilitation based on the Internet‐based rehabilitation management system on hip function, activities of daily living and somatic integrative ability of elderly postoperative hip fracture patients. Methods From June 2020 to November 2020, we recruited 58 elderly postoperative hip fracture patients and randomly assigned them to the telephone group ( n = 29) and the telerehabilitation group ( n = 29). Both groups received routine discharge instructions, and the former received telephone follow‐up after discharge, while the latter received remote rehabilitation based on the Internet‐based rehabilitation management system. The Harris hip score (HHS), functional independence measure (FIM), timed up‐and‐go test (TUG), and short physical performance battery (SPPB) were used to evaluate the patients' hip function, activities of daily living, and overall somatic ability. Results There was no significant difference between the baseline data of the two groups before the intervention ( P > 0.05); no matter after hip replacement or internal fixation, the HHS score and FIM score of both groups increased gradually with the postoperative time, and the scores in the telerehabilitation group were higher than those in the telephone group at 1 and 3 months after the intervention, and the difference was significant ( P < 0.05); for patients after hip replacement, the TUG and SPPB scores in the telerehabilitation group were better than those in the telephone group at 3 months after the intervention, and the difference was significant ( P < 0.05). Conclusions The Internet‐based rehabilitation management system applied to postoperative home rehabilitation of elderly hip fracture patients can improve the functional recovery of the hip joint and enhance the ability to perform activities of daily living and somatic integration to a certain extent. This seems to provide an effective option for conducting home rehabilitation.

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“…Delgado et al 22 investigated the influence of cognitive impairment on mortality of patients over 65 years with hip fractures and reported that dementia is a risk factor for pulmonary infections, urinary tract infection and sepsis. Barceló et al 23 assessed the causes of death in patients who died up to 2 years after hip fracture and found that circulatory system diseases and pneumonia were the most common causes of death. They also reported that decompression of chronic illness caused by hip fractures and the hip fracture itself were associated with death.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dementia on Postoperative Mortality in Elderly Patients with Hip Fracture

Cha

Yoo

et al. 2021

J Korean Med Sci

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Background The aim of this study was to assess the prevalence of dementia as an underlying disease in elderly patients with hip fracture, to investigate the effect of dementia on postoperative mortality after surgery of hip fracture, and to analyze the differences in postoperative mortalities according to the severity of dementia through subgroup analysis. Methods This study selected 2,346 elderly patients who were diagnosed with unilateral intertrochanteric or femoral neck fractures who underwent surgery between January 2004 and December 2018. The patients were classified into the non-dementia group (2,196 patients) and dementia group (150 patients; no-medication [66 patients] and medication [84 patients] subgroups). The cumulative crude mortality rate was calculated, and 30-day, 60-day, 3-month, 6-month, and 1-year mortality rates were compared between the groups. A univariate regression test was performed using age, sex, diagnosis, surgery type, and Charlson's comorbidity index (CCI), as these variables had P values of < 0.10. Multivariate regression analysis was performed to identify independent risk factors associated with mortality. Results The 30-day, 60-day, 3-month, 6-month, and 1-year postoperative cumulative mortality rates were 1.8%, 3.8%, 5.6%, 8.9%, and 13.6%, respectively, in the non-dementia group, and 2%, 7.3%, 14%, 19.3%, and 24%, respectively, in the dementia group ( P = 0.748, P = 0.048, P < 0.001, P < 0.001, and P = 0.001). The factors that affected the 1-year mortality were age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02–1.08; P < 0.001), sex (OR, 2.68; 95% CI, 2.07–3.47; P < 0.001), CCI (OR, 1.34; 95% CI, 1.23–1.47; P < 0.001), and dementia (OR, 1.70; 95% CI, 1.46–1.08; P = 0.016). In subgroup analysis, severity of dementia influenced the 6-month mortality (OR, 1.41; 95% CI, 1.70–2.01; P = 0.018), and 1-year mortality (OR, 1.30; 95% CI, 1.17–1.90; P = 0.027). Conclusion In elderly hip fracture patients, the comparison between patients with and without dementia revealed that dementia was an independent risk factor for mortality at a minimum of 1 year of follow-up, and the severity of dementia in hip fracture patients was a risk factor for mortality within 6 months and 1 year, postoperatively.

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Hip fracture and mortality: study of specific causes of death and risk factors

Cited by 46 publications

References 26 publications

Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation

Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation

Effect of Home‐based Telerehabilitation on the Postoperative Rehabilitation Outcome of Hip Fracture in the Aging Population

Effect of Dementia on Postoperative Mortality in Elderly Patients with Hip Fracture

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