Pre-fracture quality of life predicts 1-year survival in elderly patients with hip fracture—development of a new scoring system

Bliemel, Christopher; Sielski, Robert; Doering, Bettina K.; Dodel, Richard; Balzer‐Geldsetzer, Monika; Ruchholtz, Steffen; Buecking, Benjamin

doi:10.1007/s00198-015-3472-8

Cited by 35 publications

(31 citation statements)

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“…The characteristics of patients in this study are similar to those in other studies of mortality in elderly patients with hip fracture with respect to sex [13–15], age [13–15], BMI [13, 14], ASA classification [13, 15], CCI score [15], fracture location [13, 15, 16], and fracture treatment [13]. We chose to use CT to evaluate the T12 and L4 levels because this technique has been validated as prognostically significant for evaluation of the body core musculature in nonorthopedic patients [9, 25, 26] and because these areas are commonly visualized on CT scans of the chest, abdomen, pelvis, and thoracolumbar spine.…”

Section: Discussionsupporting

confidence: 79%

“…However, little is known about any association between sarcopenia and overall survival in patients with osteoporotic hip fractures, even though the mortality rates among elderly patients with hip fractures are higher than those for many forms of cancer (e.g., breast cancer) [12]. After hip fracture, the 1-year mortality rates are generally 20–30% [13–15], but reportedly can range widely from 14% to 36% [16]. In patients with hip fracture, increased mortality has been associated with increased age, male sex, and increased number of comorbidities [15, 16].…”

mentioning

confidence: 99%

“…After hip fracture, the 1-year mortality rates are generally 20–30% [13–15], but reportedly can range widely from 14% to 36% [16]. In patients with hip fracture, increased mortality has been associated with increased age, male sex, and increased number of comorbidities [15, 16]. …”

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confidence: 99%

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CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

Boutin

Bamrungchart

Bateni

et al. 2017

American Journal of Roentgenology

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OBJECTIVE Our objective was to determine the association between muscle cross-sectional area and attenuation, as measured on routine CT scans, and mortality in older patients with hip fracture. MATERIALS AND METHODS A retrospective 10-year study of patients with hip fracture was conducted with the following inclusion criteria: age 65 years or older, first-time hip fracture treated with surgery, and CT of the chest, abdomen, or pelvis. This yielded 274 patients (70.4% women; mean [± SD] age, 81.3 ± 8.3 years). On each CT scan, two readers independently measured the size (cross-sectional area, indexed for patient height) and attenuation of the paravertebral muscle at T12 and the psoas muscle at L4. We then determined the association between overall mortality and the muscle size and muscle attenuation, while adjusting for demographic variables (age, sex, ethnicity, and body mass index), American Society of Anesthesiologists (ASA) classification, and Charlson comorbidity index (CCI). RESULTS The overall mortality rate increased from 28.3% at 1 year to 79.5% at 5 years. Mortality was associated with decreased thoracic muscle size (odds ratio [OR], 0.66; 95% CI, 0.49–0.87). This association persisted after adjusting for demographic variables (OR, 0.69; 95% CI, 0.50–0.95), the ASA classification (OR, 0.70; CI, 0.51–0.97), and the CCI (OR, 0.72; 95% CI, 0.52–1.00). Similarly, decreased survival was associated with decreased thoracic muscle attenuation after adjusting for all of these combinations of covariates (OR, 0.67–0.72; 95% CI, 0.49–0.99). Decreased lumbar muscle size and attenuation trended with decreased survival but did not reach statistical significance. CONCLUSION In older adults with hip fractures, CT findings of decreased thoracic paravertebral muscle size and attenuation are associated with decreased overall survival.

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Section: Discussionsupporting

confidence: 79%

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confidence: 99%

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CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

Boutin

Bamrungchart

Bateni

et al. 2017

American Journal of Roentgenology

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“…Etwa ein Drittel der geriatrischen Patienten verstirbt innerhalb des ersten Jahres [3,21], ein weiteres Drittel wird neu institutionalisiert [13], und 5-9 % der Patienten behalten bleibende funktionelle Einschränkungen zurück [26,38]. Das Risiko, innerhalb eines Jahres eine weitere osteoporosebedingte Fraktur zu erleiden, beträgt ca.…”

Section: Outcome/prognoseunclassified

Hüftendoprothetik nach Trauma

Hack

Bücking

Eschbach

et al. 2017

Trauma Berufskrankh

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“…In Brazil, the mortality was 32% and the chance of death from falling in the elderly is significantly higher for females, age group above 69 years and elderly people with white skin color, widowed or single [6]. Performing the surgical procedure as soon as possible may decrease hospital length of staying and mortality in these patients [6][7].…”

Section: Introductionmentioning

confidence: 99%

Characterizing the fall and association between functional independence and balance in the elderly following proximal femoral surgery

Avila

Bocchi

2016

Int Arch Med

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Introduction: Falling in the elderly should be considered sentinel events in the life of an individual, potentially marking in the initiation of an important decline in his functional capacity, have a multicausal etiology and can be attributed to extrinsic factors and intrinsic factors. Objective:To characterize sociodemographics and the diseases of the elderly who sustained a proximal femoral fracture, as a result of falls from a standing height, and to study the relationship between balance and functional independence of these elderly.Method: This was a cross-sectional study conducted over a period of 12 months in a teaching hospital, with a sample of 89 elderly (≥ 60 years).Results: The characteristics of the elderly patients which demonstrated significance with functional independence were: the presence of nervous system disease, and/or mental and behavioural disorders (p = 0.001), and balance (p <0.001). Surgeries in the proximal femoral region occurred in females (67.3%), elderly patients ≥ 80 years of age (46.1%), and 60.7% underwent osteosynthesis. Conclusions:In relationship to functional independence, 23.6% of the elderly were classified as maximum dependence, 38.2% as minimum, and 38.2% as modified independence. The elderly gained balance significantly as they regained their functional independence, regardless of age, gender, and whether or not they presented with nervous system disease and/or mental and behavioural disorders.

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Pre-fracture quality of life predicts 1-year survival in elderly patients with hip fracture—development of a new scoring system

Abstract: With only four instruments, the new score represents a useful tool for estimating 1-year survival in elderly patients with hip fractures. At present, the score is limited due to a lack of validation. A validation study is currently underway to prove its reliability.

Cited by 35 publications

References 44 publications

CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

Hüftendoprothetik nach Trauma

Characterizing the fall and association between functional independence and balance in the elderly following proximal femoral surgery

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