Meta-analysis of risk factors for the second hip fracture (SHF) in elderly patients

Zhu, Yanbin; Chen, Wei; Sun, Tao; Zhang, Qi; Cheng, Jiaxiang; Zhang, Yingze

doi:10.1016/j.archger.2014.02.012

Cited by 23 publications

(26 citation statements)

References 40 publications

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“…Higher risk of second fractures was reported among patients with cognitive impairment, lower bone mass, senile dementia, respiratory diseases, and alcoholism. [3,18,19] This study has several limitations. First, it was not possible to ascertain hip fractures that occurred before 2000.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database

Juhász¹,

Boncz

Patczai

et al. 2016

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada demografik ve klinik etkenlerin ileri yaşlı Macar nüfusunda ikinci (kontralateral) kalça kırığı insidansı üzerindeki önemi Macaristan'daki ulusal sağlık sigortası veri tabanı kullanılarak araştırıldı. Hastalar ve yöntemler: Çalışmaya 2000 yılında düşük enerjili travma nedeniyle primer monotravmatik femur boyun kırıkları için tedavi edilen toplam 3.783 hasta (917 erkek, 2.866 kadın) dahil edildi. Aşağıdaki prognostik etkenleri değerlendirmek için Cox regresyon ve Kaplan-Meier sağkalım analizleri ve log sıra testi uygulandı: Yaş, cinsiyet, yaşanan yer, primer kırık tipi ve cerrahi girişim, primer kırık için tedavi veren hastane ve eşlik eden hastalıklar. Bulgular: Toplam 312 hastada (%8.2) ikinci kalça kırığı vardı. Tek değişkenli Cox regresyon analizi ikinci kalça kırığı için daha yaşlı (p= 0.001), kadın cinsiyetli (p= 0.022), başkentte yaşayan (p= 0.024) ve artroplastisi olan (p= 0.001) hastalarda anlamlı derecede daha yüksek risk gösterdi. Çok değişkenli analize göre, daha yaş (p≤0.001) ve artroplastili olmak (p= 0.004) ikinci kalça kırıkları için anlamlı risk faktörleri idi. Log sıra testi erkeklere göre kadınlarda (p<0.001) ve osteosentezli olanlara göre artroplastili hastalarda (p= 0.013) anlamlı derecede daha uzun sağkalım olduğunu gösterdi. Sonuç: Etkili korunma stratejileri oluşturmak için yüksek riskli grupların tanımlanması gereklidir. Çalışmamız ikinci kalça kırığına maruz kalma riskinin kadınlarda, ileri yaşlı nüfusta, başkentte yaşayanlarda ve artroplasti geçiren hastalarda daha yüksek olduğunu göstermektedir.Anahtar sözcükler: Yaşlı nüfus; femur boyun kırığı; insidans; risk faktörleri; ikinci kalça kırığı. ABSTRACTObjectives: This study aims to investigate the significance of demographic and clinical factors on incidence of second (contralateral) hip fracture in elderly Hungarian population using the nationwide health insurance database in Hungary. Patients and methods:The study included a total of 3,783 patients (917 males, 2,866 females) treated for primary monotraumatic femoral neck fractures caused by low-energy trauma in the year 2000. Cox regression and Kaplan-Meier survival analyses, and log-rank test were performed to evaluate the following prognostic factors: age, gender, place of living, type of primary fracture and surgical intervention, hospital providing treatment for primary fracture, and comorbidities. Results: A total of 312 patients (8.2%) suffered second hip fractures. The univariate Cox regression analysis showed a significantly higher risk for second hip fracture in patients having advanced age (p= 0.001), female gender (p= 0.022), living in capital (p= 0.024), and having arthroplasty (p= 0.001). Advanced age (p≤0.001) and having arthroplasty (p= 0.004) were significant risk factors for second hip fractures according to multivariate analysis. Log-rank test showed significantly longer survival in females (p<0.001) than in males and in patients with arthroplasty (p= 0.013) compared with those having osteosynthesis. Conclusion: Identification of high-risk groups...

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Section: Discussionmentioning

confidence: 99%

Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database

Juhász¹,

Boncz

Patczai

et al. 2016

Eklem Hastalik Cerrahisi

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“…Previous studies have shown that women and older individuals have a higher risk of hip fracture [12]. In addition to AD, other comorbidities including previous hip fractures [13], stroke [14], chronic obstructive pulmonary disease (COPD) [15] and other pulmonary diseases [12, 16], diabetes [13, 17], and cardiovascular diseases [12] increase the susceptibility to hip fracture.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to AD, other comorbidities including previous hip fractures [13], stroke [14], chronic obstructive pulmonary disease (COPD) [15] and other pulmonary diseases [12, 16], diabetes [13, 17], and cardiovascular diseases [12] increase the susceptibility to hip fracture. In addition, various medications such as analgesics, gastroprotectants and different cardiovascular medications, antidepressants, antipsychotics, antiepileptics and COPD medications have been associated with increased hip fracture risk [4, 18, 19].…”

Section: Introductionmentioning

confidence: 99%

Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer’s disease – exposure-matched cohort study

et al. 2016

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BackgroundDementia, with Alzheimer’s disease (AD) being the most common form, is a major hip fracture risk factor, but currently it is not known whether the same factors predict hip fracture among persons with and without dementia/AD. We compared the predictors of hip fracture and mortality after hip fracture in persons with and without AD.MethodsAn exposure-matched cohort of all community-dwellers of Finland who received a new clinically verified AD diagnosis in 2005–2011 and had no history of previous hip fracture (N = 67,072) and an age, sex, and region-matched cohort of persons without AD (N = 67,072). Associations between sociodemographic characteristics, comorbidities and medications and risk of hip fracture and mortality after hip fracture were assessed with Cox regression.ResultsAs expected, the incidence of hip fractures in 2005–2012 (2.19/100 person-years vs 0.90/100 person-years in the non-AD cohort), as well as mortality after hip fracture (29/100 person-years vs 23/100 person-years in the non-AD cohort) were higher in the AD cohort. This difference was evident regardless of the risk factors. Mental and behavioural disorders (adjusted hazard ratio; HR 95% confidence interval CI: 1.16, 1.09-1.24 and 1.71, 1.52-1.92 in the AD and non-AD-cohorts), antipsychotics (1.12, 1.04-1.20 and 1.56, 1.38-1.76 for AD and non-AD-cohorts) and antidepressants (1.06, 1.00-1.12 and 1.34 1.22-1.47 for AD and non-AD-cohorts) were related to higher, and estrogen/combination hormone therapy (0.87, 0.77-0.9 and 0.79, 0.64-0.98 for AD and non-AD-cohorts) to lower hip fracture risk in both cohorts. Stroke (1.42, 1.26-1.62), diabetes (1.13, 0.99-1.28), active cancer treatment (1.67, 1.22-2.30), proton pump inhibitors (1.14, 1.05-1.25), antiepileptics (1.27, 1.11-1.46) and opioids (1.10, 1.01-1.19) were associated with higher hip fracture risk in the non-AD cohort. Similarly, the associations between mortality risk factors (age, sex, several comorbidities and medications) were stronger in the non-AD cohort.ConclusionsAD itself appears to be such a significant risk factor for hip fracture, and mortality after hip fracture, that it overrules or diminishes the effect of other risk factors. Thus, it is important to develop and implement preventive interventions that are suitable and effective in this population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0383-2) contains supplementary material, which is available to authorized users.

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“…3 In fact, hip fractures are estimated to account for 72% of the total cost of fractures. 4,5 Resource allocation for hip fracture surgeries are often based on analyses for first hip fractures alone by excluding patients who presented with a history of prior fracture. [6][7][8][9] However, previous reports indicate that second hip fractures account for up to 15% of all hip fractures.…”

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confidence: 99%

The burden of second hip fractures: provincial surgical hospitalizations over 15 years

Guy

Sobolev

Kuramoto

et al. 2017

CJS

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The burden of second hip fractures: provincial surgical hospitalizations over 15 years Background: Second hip fractures account for up to 15% of all hip fractures. We sought to determine if the proportion of hip fracture surgeries for second hip fracture changed over time in terms of patient and fracture characteristics. Methods:We reviewed the records of patients older than 60 years hospitalized for hip fracture surgery between 1990 and 2005 in British Columbia. We studied the proportion of surgeries for second hip fracture among all hip fracture surgeries. Linear regression tested for trends across fiscal years for women and men. Results:We obtained 46 341 patient records. Second hip fracture accounted for 8.3% of hip fracture surgeries. For women the proportion of second hip fracture surgeries increased linearly from 4% to 13% with each age decade (p = 0.001) and across fiscal years (p = 0.002). In men the proportion of second hip fracture surgeries was 5% for each age decade between the ages of 60 and 90 years across fiscal years, increasing to 8% for men older than 90 years across fiscal years (p = 0.20). These sex-specific trends were similar for both pertrochanteric and transcervical fracture types. Conclusion:Second hip fracture surgeries account for an increasing proportion of hip fracture surgeries and may require more health care resources to minimize poorer reported outcomes. Future research should determine whether more health care resources are required to manage these patients and optimize their outcomes.Contexte : Les secondes fractures de la hanche représentent jusqu'à 15 % de la totalité des fractures de la hanche. Nous avons tenté de déterminer si la proportion de chirurgies de seconde fracture de la hanche avait évolué au fil du temps sur le plan des caractéristiques des patients et des fractures.

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Meta-analysis of risk factors for the second hip fracture (SHF) in elderly patients

Cited by 23 publications

References 40 publications

Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database

Risk factors for contralateral hip fractures following femoral neck fractures in elderly: analysis of the Hungarian nationwide health insurance database

Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer’s disease – exposure-matched cohort study

The burden of second hip fractures: provincial surgical hospitalizations over 15 years

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