One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study

Abstract

Older adult patients with hip fractures are 3–4 times more likely to die within one-year after surgery than general population. The study aimed to identify independent predictive factors associated with one-year mortality after hip fracture surgery. A prospective prognostic cohort study was performed. All patients aged ≥65 years, consecutively admitted in three Italian hospitals with a diagnosis of fragility hip fracture were included. Patients with periprosthetic or pathological fractures were excluded. Multivariate analysis was used to determine variables that significantly increased the risk of one-year mortality and Receiver operating characteristic (ROC) curve analysis to assess their predictive capacity on the outcome.1083 patients fulfilled the inclusion criteria and the one-year follow-up was reached in 728 patients. The 16.6% of patients died within one-year after surgery. At the multivariate analysis, advancing age (OR = 1.094, 95% CI = 1.057–1.132), higher baseline Charlson Index (OR = 1.257, 95% CI = 1.114–1.418) and Activities of Daily Living scores (OR = 1.259, 95% CI = 1.143–1.388), presence of hospital-acquired pressure ulcers (PUs) (OR = 1.579, 95% CI = 1.002–2.489) and lack recovery of ambulation (OR = 1.736, 95% CI = 1.115–2.703), were found to be independent predictive factors of one-year mortality after surgery. The area under the ROC curve of the model was 0.780 (CI95% 0.737–0.824) for one-year mortality in elderly hip fractures patients. Early ambulation and careful long-term follow-up, with attention to frailty in elderly people, should be promoted.

Internal Fixation versus Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and Meta‐Analysis

“…In this meta-analysis, there was no significant difference in mortality within 1 year and within 2 years between the internal fixation group and the hemiarthroplasty group. Morri 24 points out that the main causes of death within 1 year of hip fracture were older age, more comorbidities, and physical weakness. The degree of hip function recovery affects patients' quality of life.…”

Increased Acid-Producing Diet and Past Smoking Intensity Are Associated with Worse Prognoses among Breast Cancer Survivors: A Prospective Cohort Study

“…These studies followed apparently healthy individuals without cancer at baseline [ 10 , 29 , 30 ]; thus, whether dietary acid load is associated with total and cancer-specific mortality among cancer survivors cannot be concluded from these studies. Dietary acid load has been shown to increase the risk of hypertension, diabetes, chronic kidney diseases, and hip fractures in cohort studies [ 31 , 32 , 33 , 34 , 35 ]; all of these are risk factors for total mortality [ 36 , 37 , 38 ]. Furthermore, animal studies have shown that metabolic acidosis can lead to increased cancer development and metastasis [ 39 ].…”

Показники 12-Місячної Летальності У Хворих З Переломом Проксимального Відділу Стегнової Кістки

“…Частота переломів даної локалізації прогресивно збільшується з віком, переважає в жінок і пов'язана з прогресуючою втратою міцності кісткової тканини й розвитком системного остеопорозу. Проведені останніми роками дослідження продемонстрували, що показники летальності у хворих з переломами ПВСК найбільші протягом першого року після перелому [5,6,8].…”

“…Поворознюка [5] та R. Civinini [9], 22 % у дослідженні M. Gurger [10], 27 % у дослідженні I.S. Cenzer [11] та 33 % у дослідженні O. Guzon-Illescas [8].…”