Influence of surgical parameters on mortality after surgery for extracapsular hip fractures in the elderly

Caramés, Laura Coto; Vilar, Pablo Ignacio Codesido; Pérez, Manuel Bravo; Revilla, Germán Alejandro Mendoza; Ojeda-Thies, Cristina; Hortas, Andrés Blanco; García, Luis Alberto Quevedo

doi:10.1016/j.recote.2020.07.003

Cited by 5 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with hip fracture, postoperative functional recovery and QoL are highly associated with multiple variables, including age, sex, medical complications, baseline Charlson Comorbidity Index (CCI), and sarcopenia [8][9][10]. The influence of surgical delay on postoperative prognosis was deleterious.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Mortality, Activity of Daily Living, and Quality of Life in Taiwanese Older Patients within 1 Year Following Hip Fracture Surgery

Chiang

Huang

Kuo

et al. 2022

JPM

View full text Add to dashboard Cite

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

show abstract

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Mortality, Activity of Daily Living, and Quality of Life in Taiwanese Older Patients within 1 Year Following Hip Fracture Surgery

Chiang

Huang

Kuo

et al. 2022

JPM

View full text Add to dashboard Cite

show abstract

“…On the basis of potential prognostic factors in the older adults, a strati ed care approach can be developed for providing intensive care to older patients with hip fracture who have a high risk of poor outcomes (12). Several factors, such as age, sex, cognitive impairment, and pre-fracture Charlson comorbidity index (CCI) score, serum hemoglobin level, serum albumin level, and surgical factors including delay in operation for predicting the functional outcomes of hip fracture surgery in older patients exhibit high variance (13)(14)(15)(16)(17). The present study aimed to evaluate the impact of the short-term functional changes from pre-fracture on long-term outcomes and compare their association with other established clinical predictors.…”

Section: Introductionmentioning

confidence: 99%

Minimal Short-Term Decline in Functional Performance and Quality of Life Predicts Better Long-Term Outcomes for Both in Older Taiwanese Adults After Hip Fracture Surgery: A Prospective Study

Yang

Kuo

Huang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Hip fracture can lead to long-term loss of mobility and self-care ability in older adults. Despite initial decreases in functional performance after hip fracture surgery, patients tend to gradually recover. However, recovery can vary, with some regaining their abilities quickly while others becoming functionally dependent. In this study, we investigated whether the level of short-term postoperative decline in activity of daily living (ADL) performance and quality of life (QoL) can predict the 1-year outcomes for both following hip fracture surgery in older Taiwanese adults. Methods This prospective cohort study included 427 older adults (≥ 60 years) who underwent hip fracture surgery at a single tertiary medical center in Taiwan between November 2017 and March 2021. We collected pre-fracture data, including the patients’ demographics, Charlson comorbidity index (CCI) scores, and responses to a questionnaire (Short Portable Mental State Questionnaire [SPMSQ]) for dementia screening. Moreover, their scores on the EuroQol-5D questionnaire (for evaluating QoL) and Barthel Index (for assessing ADL performance) were collected at pre-fracture status and 3 and 12 months after surgery. Changes in ADL and QoL three months post-surgery compared to pre-fracture status were evaluated, and the associations of these parameters (and other potential factors) with 1-year outcomes for ADL and QoL were investigated. Results We analyzed the data of 318 patients with hip fracture and complete follow-up data regarding ADL performance and QoL 3 and 12 months after surgery. After adjusting for covariates, multivariate logistic regression revealed that changes in ADL and QoL 3 months post-surgery from pre-fracture status were positively and significantly correlated with 1-year outcomes for both (p < .001 for both). Furthermore, pre-fracture CCI and SPMSQ scores were independent predictive factors associated with 1-year ADL outcomes (p = .042 and < .001, respectively). Conclusions Patients who exhibit a smaller decline in functional performance and quality of life three months after hip fracture surgery from pre-fracture status are likely to have improved long-term ADL and QoL. Our results provide valuable clinical insights for future research aimed at enhancing ADL and QoL in older patients after hip fracture surgery by advocating for early postoperative interventions. Trial registration: TMU-JIRB N201709053

show abstract

“…On the basis of potential prognostic factors in the older adults, a stratified care approach can be developed for providing intensive care to older patients with hip fracture who have a high risk of poor outcomes [ 13 ]. Several factors, such as age, sex, cognitive impairment, and pre-fracture Charlson comorbidity index (CCI) score, serum hemoglobin level, serum albumin level, and surgical factors including delay in operation for predicting the functional outcomes of hip fracture surgery in older patients exhibit high variance [ 14 – 17 ]. The present study aimed to evaluate the impact of short-term functional changes from pre-fracture on long-term outcomes and compare their association with other established clinical predictors.…”

Section: Introductionmentioning

confidence: 99%

Minimal short-term decline in functional performance and quality of life predicts better long-term outcomes for both in older Taiwanese adults after hip fracture surgery: a prospective study

Yang,

Kuo,

Huang

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Background Hip fracture can lead to long-term loss of mobility and self-care ability in older adults. Despite initial decreases in functional performance after hip fracture surgery, patients tend to gradually recover. However, recovery can vary, with some regaining their abilities quickly while others becoming functionally dependent. In this study, we investigated whether the level of short-term postoperative decline in activity of daily living (ADL) performance and quality of life (QoL) can predict the 1-year outcomes for both following hip fracture surgery in older Taiwanese adults. Methods This prospective cohort study included 427 older adults (≥ 60 years) who underwent hip fracture surgery at a single tertiary medical center in Taiwan between November 2017 and March 2021. We collected pre-fracture data, including the patients’ demographics, Charlson comorbidity index (CCI) scores, and responses to a questionnaire (Short Portable Mental State Questionnaire [SPMSQ]) for dementia screening. Moreover, their scores on the EuroQol-5D questionnaire (for evaluating QoL) and the Barthel Index (for assessing ADL performance) were collected at pre-fracture status and at 3- and 12-months following surgery. Changes in ADL and QoL three months post-surgery compared to pre-fracture status were evaluated, and the associations of these parameters (and other potential factors) with 1-year outcomes for ADL and QoL were investigated. Results We analyzed the data of 318 patients with hip fracture and complete follow-up data regarding ADL performance and QoL at 3- and 12-months post-surgery. After adjusting for covariates, multivariate linear regression revealed that changes in ADL and QoL at 3 months post-surgery from pre-fracture status were positively and significantly associated with 1-year outcomes for both (p < .001 for both). Furthermore, pre-fracture CCI and SPMSQ scores were independent predictive factors associated with 1-year ADL outcomes (p = .042 and < .001, respectively). Conclusions Patients who exhibit a smaller decline in functional performance and quality of life three months after hip fracture surgery from pre-fracture status are likely to have improved long-term ADL and QoL. Trial registration: TMU-JIRB N201709053.

show abstract

Influence of surgical parameters on mortality after surgery for extracapsular hip fractures in the elderly

Cited by 5 publications

References 25 publications

Prognostic Factors for Mortality, Activity of Daily Living, and Quality of Life in Taiwanese Older Patients within 1 Year Following Hip Fracture Surgery

Prognostic Factors for Mortality, Activity of Daily Living, and Quality of Life in Taiwanese Older Patients within 1 Year Following Hip Fracture Surgery

Minimal Short-Term Decline in Functional Performance and Quality of Life Predicts Better Long-Term Outcomes for Both in Older Taiwanese Adults After Hip Fracture Surgery: A Prospective Study

Minimal short-term decline in functional performance and quality of life predicts better long-term outcomes for both in older Taiwanese adults after hip fracture surgery: a prospective study

Contact Info

Product

Resources

About