Risk factors and complications contributing to mortality in elderly patients with fall-induced femoral fracture: A cross-sectional analysis based on trauma registry data of 2,407 patients

Chou, Sheng-En; Rau, Cheng-Shyuan; Tsai, Yu-Chin; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

doi:10.1016/j.ijsu.2019.04.010

Cited by 16 publications

(14 citation statements)

References 32 publications

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“…There were significant differences among the three groups in the distribution of cases by fracture site. Similarly, in previous studies, femoral shaft fractures were found to be the most commonly diagnosed femoral fractures in a pediatric population, 28,35–37 approximately 90% of femur fractures occur in the proximal femur in adults, 38 and older patients were found to be at a higher risk of developing proximal fractures 4–6 . Potential factors that may explain the difference in femur fracture patterns in pediatric patients compared to adult femur fractures are osteoporosis and a different manner of falling, including an increased risk of falling due to medication or impaired balance 39 .…”

Section: Discussionmentioning

confidence: 54%

“…Respiratory complications contributed greatly to mortality in elderly patients with femoral fracture after a fall from ground level. Thus, aggressive chest‐protective measures are encouraged to decrease the respiratory complications associated with femoral fracture in elderly patients 6 …”

Section: Discussionmentioning

confidence: 99%

“…Femoral fractures are a common cause of mortality and functional loss, mainly among older people 1–12 . Aging, which includes age‐related biomechanical changes in bone strength, and falling from a standing height or a lower height are the most common mechanisms of fragility‐related fractures among older people, and the incidence of these fractures is increasing 1–5 .…”

Section: Introductionmentioning

confidence: 99%

“…The consequences of falls in elderly people often include fractures, immobility, and impairment and sometimes include death. In recent years, there have been many reports about traumatic femoral fractures 4–12 . However, there are few studies about the age differences related to traumatic femoral fractures 5,12–14 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of Age on the Patterns of Traumatic Femoral Fractures: Seven Years of Experience at a Regional Tertiary Hospital

Yuan

Zhu

et al. 2022

Orthopaedic Surgery

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Objective Femoral fractures are a common cause of mortality and functional loss, mainly among older people, and there are few studies about the age in relation to traumatic femoral fractures. The aim of this study was to investigate the effect of age on the patterns of traumatic femoral fractures in patients presenting to our regional tertiary hospital. Methods The records of 2020 patients who presented with traumatic femoral fractures between 2013 and 2019 were retrospectively reviewed. The patients' clinical and radiographic records were reviewed. Univariate and multivariable logistic regression were used to identify independent risk factors for associated injuries and complications. Results The patients were divided into a child group (CH group, n = 342) aged under 18 years, a young adult group (YA group, n = 484) aged 18–60 years, and an older people group (OP group, n = 1194) aged 60 years and over. There were significant differences among the three groups in several indexes, such as sex ratio (χ2 = 301.699, p < 0.001), osteoporosis (χ2 = 375.463, p < 0.001), injury time of day (χ2 = 114.913, p < 0.001), injury cause (χ2 = 748.187, p < 0.001), injury location (χ2 = 490.153, p < 0.001), fracture side (χ2 = 57.000, p < 0.001), fracture site (χ2 = 806.650, p < 0.001), associated injuries (χ2 = 322.921, p < 0.001), coma after injury (χ2 = 147.814, p < 0.001), non‐surgery‐related complications (χ2 = 7.895, p = 0.019), and surgery‐related complications (χ2 = 82.186, p < 0.001). The YA group had a significantly higher percentage of patients with surgery‐related complications than the OP group. The OP group had a higher frequency of non‐surgery‐related complications than the YA group and CH group. The most common non‐surgery‐related complications were pneumonia (7.1%) in the OP group and deep venous thrombosis (6.4%) in the YA group. Multivariable logistic regression showed that young adults, high‐energy injury, outdoors, coma after injury, and fracture sites except for the proximal region were independent risk factors for associated injuries. Older age, male, and fracture site except for the proximal region were independent risk factors for complications. Conclusions Traumatic femoral fractures are mostly the result of low‐energy trauma and predominantly affect the proximal site of the femur among older people. A higher rate of shaft fractures, fractures occurring outdoors, and associated injuries were observed among young adults and children than among older people.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Age on the Patterns of Traumatic Femoral Fractures: Seven Years of Experience at a Regional Tertiary Hospital

Yuan

Zhu

et al. 2022

Orthopaedic Surgery

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“…In these patients the immune system is in constant exposure to the antigen stimuli of Staphylococcus aureus that is the commonest pathogen. Due to their profile these patients are prone to subsequent severe infections like bacteremia, lung infection and urinary tract infection that may put their life in danger 4,5 . Severe infection i.e.…”

mentioning

confidence: 99%

Staphylococcus Aureus Osteomyelitis as an Inducer of Tolerance to Escherichia Coli Pyelonephritis: an Experimental Study

Goumenos

Savvidou

Renieris

et al. 2020

Sci Rep

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the high incidence of osteomyelitis in vulnerable populations like those with multiple injuries or elderly undergoing joint arthroplasties generates the question what may be their responses to subsequent infection by high virulent isolates. Rabbits were subject to two operations at three week intervals; sham osteomyelitis and sham pyelonephritis (group S); sham osteomyelitis and Escherichia coli pyelonephritis (group p); and Staphylococcus aureus osteomyelitis and E. coli pyelonephritis (group op). Survival was recorded; cytokine stimulation of circulating mononuclear cells (pBMcs) and tissue myeloperoxidase (Mpo) activity and bacterial growth were monitored. in some experiments, dalbavancin treatment was given before pyelonephritis. Healthy pBMcs were pre-treated with bone homogenate, S. aureus or both. Mortality of groups S, P and OP after induction of pyelonephritis was 0%, 50% and 8.3% respectively. tumour necrosis factor-alpha (tnfα) production by PBMCs was significantly lower in the OP group at 48 hours. E. coli bacterial load was similar in groups P and OP at death or sacrifice whereas the Mpo activity of group op was decreased. production of tnfα was further decreased among dalbavancin treated rabbits; in these rabbits tissue Mpo was increased. tnfα production decreased when healthy pBMcs pre-treated with bone homogenate, S. aureus (HKSA) or both were stimulated with E. coli (HKEC); production was further decreased in the presence of anti-TLR4 and anti-TLR9. It is concluded that staphylococcal osteomyelitis modulated the innate immune responses of the host leading to protection from death by highly virulent E. coli. tolerance to tLR ligands is the most likely mechanism of action.

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Trauma-related acute kidney injury during inpatient care of femoral fractures increases the risk of mortality: A claims data analysis

Büchele

Rehm

Halbgebauer

et al. 2022

American Journal of Medicine Open

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Risk factors and complications contributing to mortality in elderly patients with fall-induced femoral fracture: A cross-sectional analysis based on trauma registry data of 2,407 patients

Cited by 16 publications

References 32 publications

Effect of Age on the Patterns of Traumatic Femoral Fractures: Seven Years of Experience at a Regional Tertiary Hospital

Effect of Age on the Patterns of Traumatic Femoral Fractures: Seven Years of Experience at a Regional Tertiary Hospital

Staphylococcus Aureus Osteomyelitis as an Inducer of Tolerance to Escherichia Coli Pyelonephritis: an Experimental Study

Trauma-related acute kidney injury during inpatient care of femoral fractures increases the risk of mortality: A claims data analysis

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