Long-Term Mortality After Osteoporotic Hip Fracture in Chiang Mai, Thailand

Vaseenon, Tanawat; Luevitoonvechkij, Sirichai; Wongtriratanachai, Prasit; Rojanasthien, S.

doi:10.1016/j.jocd.2009.10.003

Cited by 41 publications

(33 citation statements)

References 16 publications

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“…The 5-year mortality rates are similar to previously published studies 22 in Asian populations and reflect previous identification of hip fracture as an independent predictor of 5-year mortality in a similar population. 23 The relatively high 5-year mortality rates reflect the frailty of the osteoporotic fracture population and highlight the importance of identifying hip fractures as sentinel events limiting the longevity of geriatric patients.…”

Section: Discussionsupporting

confidence: 89%

Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

Jiang

Chou

Nadkarni

et al. 2018

Geriatr Orthop Surg Rehabil

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Introduction:This study aims to assess the correlation of the age-adjusted Charlson comorbidity index (ACCI) with 5-year mortality in a surgically treated hip fracture population.Materials and Methods:A retrospective analysis was performed on 1057 patients aged 60 years and above who underwent surgery for hip fracture with a minimum of 5-year follow-up (92.2% 5-year follow-up rate) in a tertiary hospital. Manual review of patients’ electronic hospital records was performed to record demographic data, comorbidities, and length of stay. Mortality data were extracted from the hospital’s electronic medical records and corroborated with the National Electronic Health Record.Results:Of the 1057 patients, 283 (26.8%) were male. The majority of patients were 80 years of age and above (42.5%), with the oldest patient operated on age 102 with a mean age of 77.8 (8.6) years. Four hundred eighteen (39.5%) patients sustained extracapsular intertrochanteric fractures. The mean follow-up duration was 8 years and 3 days with an overall survivorship of 37.2%. A multiple regression model constructed with ACCI, age, gender, and fracture pattern demonstrated satisfactory predictive ability with a concordance statistic of 0.68. Patients with a higher ACCI category (≥6) had an increased 5-year mortality rate (41.8%) with an odds ratio of 13.6 (6.7-31.8, P < .001) compared to those with an ACCI category of 3 and below (89.3%).Discussion:The study demonstrates that ACCI correlated with 5-year mortality after surgical treatment of hip fracture. This information is pertinent in the counseling of patients with regard to their midterm survival following hip fracture surgery and may inform policy makers of the varied midterm survival rates in patients with differing ACCI scores and educate the allocation of health-care resources.Conclusion:The ACCI correlates with 5-year mortality after surgical treatment of hip fracture.

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Section: Discussionsupporting

confidence: 89%

Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

Jiang

Chou

Nadkarni

et al. 2018

Geriatr Orthop Surg Rehabil

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“…There is a general consensus in the literature that mortality is associated with age, sex, comorbidity, functional status, dementia, arrhythmia and congestive heart failure. We noted conflicting reports for the association between mortality and both fracture type [ 17 , 65 ] and delirium [ 47 , 62 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

“… Hypothesis only The number of chronic conditions increases with age [ 47 , 70 ]. Extent of comorbidity Sex Men present with more comorbidity than women [ 47 , 54 , 65 , 68 ]. Extent of comorbidity Men develop delirium [ 60 ], lung infection, pneumonia, and septicemia more often than women [ 54 , 68 ].…”

Section: Methodsmentioning

confidence: 99%

Patient and system factors of mortality after hip fracture: a scoping review

Sobolev

Chudyk²,

Stephens

et al. 2016

BMC Musculoskelet Disord

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BackgroundSeveral patient and health system factors were associated with the risk of death among patients with hip fracture. However, without knowledge of underlying mechanisms interventions to improve survival post hip fracture can only be designed on the basis of the found statistical associations.MethodsWe used the framework developed by Arksey and O’Malley and Levac et al. for synthesis of factors and mechanisms of mortality post low energy hip fracture in adults over the age of 50 years, published in English, between September 1, 2009 and October 1, 2014 and indexed in MEDLINE. Proposed mechanisms for reported associations were extracted from the discussion sections.ResultsWe synthesized the evidence from 56 articles that reported on 35 patient and 9 system factors of mortality post hip fracture. For 21 factors we found proposed biological mechanisms for their association with mortality which included complications, comorbidity, cardiorespiratory function, immune function, bone remodeling and glycemic control.ConclusionsThe majority of patient and system factors of mortality post hip fracture were reported by only one or two articles and with no proposed mechanisms for their effects on mortality. Where reported, underlying mechanisms are often based on a single article and should be confirmed with further study. Therefore, one cannot be certain whether intervening on such factors may produce expected results.

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“…Many factors, including age, gender, physical status, institutionalization, comorbidities, findings of laboratory evaluations, method of treatment, and time to surgery have been reported to be associated with in-hospital, 30-day, and 1-year mortality after a hip fracture in diverse populations and countries [ 3 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. In Thailand, data from Chiang Mai University show factors correlated with mortality after hip fracture in the periods 1997 through 1998, 1998 through 2003, and 2006 through 2007 including male gender, greater age, nonoperative treatment, surgical treatment delayed more than a week, chronic illnesses, poor pre-fracture walking ability, and absence of medical treatment for osteoporosis [ 34 , 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

“…Specific types of comorbidities and laboratory evaluation findings have been identified as major factors associated with mortality after a hip fracture [ 3 , 16 , 17 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 37 , 38 ]. Previous studies of Thai patients, however, have not included these factors in their evaluations of mortality in Thai hip fracture patients [ 34 , 35 , 36 ]. Additionally, many new factors related to mortality in hip fracture patients have been described in the past decade [ 24 , 25 , 26 , 27 , 29 , 38 ], suggesting the need for a reevaluation of prognostic factors for all-cause mortality after hip fracture.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

et al. 2020

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Background and Objectives: Although the types of comorbidities and laboratory evaluations are major factors associated with mortality after hip fractures, there have been no studies of the association of these factors and mortality in Thai hip-fracture patients. This study aimed to identify prognostic factors associated with mortality after a hip fracture in the Thai population, including types of comorbidities, treatment-related factors, and laboratory evaluations. Materials and Methods: This five-year retrospective study was conducted in a tertiary care hospital in Thailand. A total of 775 Thai patients who had been admitted with a hip fracture resulting from a simple fall were identified using the International Classification of Disease 10 codes, and a review of their medical charts was conducted. Associations between general factors, comorbidities, laboratory evaluations, treatment factors including type of treatment, and time to death were analyzed using the Cox proportional hazard regression and the hazard ratio (HR). Results: The overall mortality rate of hip fracture patients was 13.94%. Independent prognostic factors found to be significantly associated with mortality were nonoperative treatment (HR = 3.29, p < 0.001), admission glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 (HR = 3.40, p < 0.001), admission hemoglobin concentration <10 g/dL. (HR = 2.31, p < 0.001), chronic obstructive pulmonary disorder (HR = 2.63, p < 0.001), dementia or Alzheimer’s disease (HR = 4.06, p < 0.001), and active malignancy (HR = 6.80, p < 0.001). Conclusion: The types of comorbidities and laboratory evaluation findings associated with mortality in Thai patients with hip fractures include chronic obstructive pulmonary disorder, dementia or Alzheimer’s disease, active malignancy, admission GFR < 30 mL/min/1.73 m2, and admission hemoglobin concentration <10 g/dL. The risks of mortality for Thai hip-fracture patients with these comorbidities or laboratory evaluation findings were 2.5, 4, 7, 3.5, and 2.5 times higher, respectively, than patients without those factors.

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Long-Term Mortality After Osteoporotic Hip Fracture in Chiang Mai, Thailand

Cited by 41 publications

References 16 publications

Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

Patient and system factors of mortality after hip fracture: a scoping review

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

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