Predicting Early Mortality After Hip Fracture Surgery: The Hip Fracture Estimator of Mortality Amsterdam

Karres, Julian; Kieviet, Noera; Eerenberg, Jan-Peter; Vrouenraets, B. C.

doi:10.1097/bot.0000000000001025

Cited by 61 publications

(49 citation statements)

References 28 publications

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“…Our work confirms the few previous reports that have shown that urea is associated with increased mortality in HF patients [14,18] and numerous studies demonstrating such link in older adults with serious illnesses. Our results, however, are the first to demonstrate in HF patients an association between admission urea and HPIR, indicating that blood nitrogen homeostasis is an important regulator of susceptibility and response to inflammation/infection.…”

Section: Hpir (33)supporting

confidence: 92%

“…Only few studies focussed on urea, and the published data have been conflicting. Elevated urea on admission has been reported as an independent predictor of in-hospital mortality [14] and included in some scoring models [17,18,51], but according to other studies urea was only marginally related [16] or not correlated with fatal short-and long-term outcome [15,52].…”

Section: Hpir (33)mentioning

confidence: 99%

“…In the past decade a number of studies have aimed to identify clinical factors and/or biomarkers of poor outcome in HF patients. The available prediction tools [63 -68] are complex (need of special rating scales and calculations), time consuming, some include subjective assessment or show significant lack of fit [18,69], and are not widely used in clinical practice. The presented here approach is based on routinely collected objective data, simple, easy to use and has a fair precision rate.…”

Section: Predictive Value Of Elevated Ureamentioning

confidence: 99%

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Prognostic Significance Of Serum Urea Concentration at Admission in older patients with hip fracture

Fisher¹,

Fisher²,

Srikusalanukul³

et al. 2018

Open Orthopaed. J.

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Background: There are unmet needs in objective prognostic indicators for Hip Fracture (HF) outcomes. Objectives: To evaluate the determinants and prognostic impact of elevated serum urea, a key factor of nitrogen homeostasis, in predicting hospital mortality, inflammatory complications and length of stay in HF patients. Methods: In 1819 patients (mean age 82.8±8.1 years; 76.4% women) with osteoporotic HF, serum urea level at admission along with 22 clinical and 35 laboratory variables were analysed and outcomes recorded. The results were validated in a cohort of 455 HF patients (age 82.1±8.0 years, 72.1% women). Results: Elevated serum urea levels (>7.5mmol/L) at admission were prevalent (44%), independently determined by chronic kidney disease, history of myocardial infarction, anaemia, hyperparathyroidism, advanced age and male gender, and significantly associated with higher mortality (9.4% vs. 3.3%, p<0.001), developing a high postoperative inflammatory response (HPIR, 22.1% vs.12.1%, p=0.009) and prolonged hospital stay (>20 days: 31.2% vs. 26.2%, p=0.021). The predictive value of urea was superior to other risk factors, most of which lost their discriminative ability when urea levels were normal. Patients with two abnormal parameters at admission, compared to subjects with the normal ones, had 3.6-5.6-fold higher risk for hospital mortality, 2.7-7.8-fold increase in risk for HPIR and 1.3-1.7-fold higher risk for prolonged hospital stay. Patients with increased admission urea and a high inflammatory response had 9.7 times greater mortality odds compared to patients without such characteristics. Conclusion: In hip fracture patients admission serum urea is an independent and valuable predictor of hospital outcomes, in particular, mortality.

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Section: Hpir (33)supporting

confidence: 92%

Section: Hpir (33)mentioning

confidence: 99%

Section: Predictive Value Of Elevated Ureamentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Significance Of Serum Urea Concentration at Admission in older patients with hip fracture

Fisher¹,

Fisher²,

Srikusalanukul³

et al. 2018

Open Orthopaed. J.

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“…1 , and the main characteristics of the included trials were summarized in Table 1 . Fourteen of 18 were prospective cohort studies [ 7 – 20 ], and four were retrospective cohort studies [ 21 – 24 ]. These studies enrolling 295,285 subjects were published between 2000 and 2018, with a sample size ranging from 272 to 134,144.…”

Section: Resultsmentioning

confidence: 99%

Association between dementia and mortality in the elderly patients undergoing hip fracture surgery: a meta-analysis

et al. 2018

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ObjectiveThis study was designed to verify the association between dementia and mortality in the elderly undergoing hip fracture surgery, and assessed the mortality of patients with dementia after hip fracture surgery.Material and methodsPubMed, Embase, and Web of Science were searched until April, 2018 without language restrictions. Two reviewers selected related studies, assessed study quality, and extracted data independently. Risk ratios (RRs) with 95% confidence intervals (CI) were derived using random-effects model throughout all analyses. The endpoints included 30-day, 6-month, 1-year, and more than 1-year mortality. This meta-analysis was performed following PRISMA statement and carried out by using stata14.0 software.ResultsDementia significantly increased postoperative mortality of patients suffered from hip fracture in 30-day [RR = 1.57, 95% CI (1.29, 1.90), P<0.00], 6-month [RR = 1.97, 95% CI (1.47, 2.63), P<0.00], 1-year [RR = 1.77, 95% CI (1.54, 2.04), P<0.00], and more than 1-year follow up [RR = 1.60, 95% CI (1.30, 1.96), P<0.00] respectively. The mortality of dementia patients after hip fracture surgery in 30-day [ES = 12%, 95% CI (8%, 15%)], 6-month [ES = 32%, 95% CI (17%, 48%)], 1-year [ES = 39%, 95% CI (35%, 43%)], and more than 1-year follow up [ES = 45%, 95% CI (32%, 58%)].ConclusionsOur meta-analysis demonstrated that the mortality of patients with dementia suffered from hip fracture surgery is 12%, 32%, 39%, and 45%, and dementia increased 1.57, 1.97, 1.77, and 1.60-fold mortality in patients undergoing hip fracture surgery in 30-day, 6-month, 1-year, and more than 1-year follow up respectively.

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“…Femoral intertrochanteric fracture and femoral neck fracture are the two main types. Hip fracture is regarded as a result of demographic aging, and age is the major risk factor for mortality in patients with hip fractures [ 4 , 5 ]. Hip fractures can exact a terrible toll on the elderly and lead to severe complications and high mortality due to their severity and high economic cost [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis

et al. 2019

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Summary We used statistical approaches to calculate 1-year mortality rates and reveal the relationship between age and the 1-year mortality rate after hip fracture based on data from mainland China between the years 2000 and 2018. Introduction Data on the 1-year mortality rates after hip fracture in mainland China remain limited and localized. We aimed to analyze the 1-year mortality rates and reveal the variations in 1-year mortality by age after hip fracture based on data from mainland China. Methods We searched PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed for all relevant articles in English or Chinese to estimate the 1-year mortality rates after hip fracture in mainland China. A random-effects meta-analysis model was fitted to pool the overall 1-year mortality rates. A multilevel mixed-effects meta-regression model was developed. Based on the final model, the age-specific 1-year mortality rates after hip fracture in mainland China were generated. Results The pooled estimate of the 1-year mortality rate was 13.96% after hip fracture (95% CI 12.26 to 15.86%), 17.47% after femoral intertrochanteric fracture (95% CI 14.29 to 21.20%), and 9.83% after femoral neck fracture (95% CI 6.96 to 13.72%) between the years 2000 and 2018. We found that the 1-year mortality rates ranged from 2.65% (95% CI 1.76 to 3.99%) in those aged 50~54 years to 28.91% (95% CI 24.23 to 34.30%) in those aged 95~99 years after hip fracture; ranged from 1.73% (95% CI 0.58 to 4.99%) in those aged 50~54 years to 50.11% (95% CI 46.03% to 53.97%) in those aged 95~99 years after femoral intertrochanteric fracture; and ranged from 1.66% (95% CI 1.31 to 2.11%) in those aged 60~64 years to 37.71% (95% CI 27.92 to 48.63%) in those aged 95~99 years after femoral neck fracture. Conclusion In this systematic review and meta-analysis, we calculated the 1-year mortality rate after hip fracture in mainland China and found that this rate was lower than that in most countries. We also estimated the age-specific mortality rates for different age groups after hip fracture. These findings will be beneficial for the prevention and treatment of hip fracture in mainland China. Electronic supplementary material The online version of this article (10.1007/s11657-019-0604-3) contains supplementary material, which is available to authorized users.

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Predicting Early Mortality After Hip Fracture Surgery: The Hip Fracture Estimator of Mortality Amsterdam

Abstract: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 61 publications

References 28 publications

Prognostic Significance Of Serum Urea Concentration at Admission in older patients with hip fracture

Prognostic Significance Of Serum Urea Concentration at Admission in older patients with hip fracture

Association between dementia and mortality in the elderly patients undergoing hip fracture surgery: a meta-analysis

Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis

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