Risk factors for mortality after hip fracture surgery in Japan using the National Database of Health Insurance Claims and Specific Health Checkups of Japan

Nishimura, Yuki; Inagaki, Yusuke; Noda, Tatsuya; Nishioka, Yuichi; Myojin, Tomoya; Ogawa, Makoto; Kido, Akira; Imamura, Tomoaki; Tanaka, Yasuhito

doi:10.1007/s11657-023-01293-z

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…According to our previous systematic analysis, the pooled estimate of the 1-year mortality rate was 17.47% after femoral intertrochanteric fracture and 9.83% after femoral neck fracture between 2000 and 2018 [ 3 ]. Many studies [ 4 – 6 ] on hip fractures have described high mortality rates. Most studies document an increase in mortality lasting for 6 to 12 months [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

One-year mortality risk in older individuals with femoral intertrochanteric fracture: a tertiary center in China

Hao,

Wang,

Chen

et al. 2024

BMC Geriatr

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Background The accelerated growth of older individuals worldwide has increased the number of patients presenting with fragility hip fractures. Having a hip fracture can cause excess mortality, and patients with hip fracture have a higher risk of death than those without hip fracture. Most studies have treated hip fracture as a single, homogeneous condition, but hip fracture includes two major anatomic types: intertrochanteric fracture and femoral neck fracture. Few studies have specifically evaluated 1-year mortality risk in older individuals with femoral intertrochanteric fracture. The aim of this study was to evaluate 1-year mortality and factors associated with mortality in older individuals with femoral intertrochanteric fracture. Methods A retrospective review was conducted of 563 patients ≥ 65 years old who underwent surgery for femoral intertrochanteric fractures at our institution between January 2010 and August 2018. Patient demographics, comorbidities, and treatment were collected by retrospective chart review. Age, sex, Body Mass Index (BMI), American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI), Arbeitsgemeinschaft Für Osteosynthesefragen (AO) fracture classification, haemoglobin value at admission, time to surgery, operation time, and intraoperative blood loss were risk factors to be tested. Multivariable logistic regression was used to evaluate associations between variables and death. Results Among the 563 patients, 49 died within 1 year after surgery, and the 1-year mortality rate was 8.7%. Multivariate analysis identified age > 80 years (OR = 4.038, P = 0.011), haemoglobin < 100 g/l (OR = 2.732, P = 0.002), ASA score ≥ 3 (OR = 2.551, P = 0.005), CCI ≥ 3 (OR = 18.412, P = 0.018) and time to surgery > 14 d (OR = 3.907, P = 0.030) as independent risk factors for 1-year mortality. Comorbidities such as myocardial infarction and chronic pulmonary disease were associated with 1-year mortality after adjusting for age > 80 years and time to surgery > 14 days. Conclusions Patients over 80 years old with haemoglobin < 100 g/l, ASA score ≥ 3, CCI ≥ 3, and multiple comorbidities, especially myocardial infarction and chronic pulmonary disease before surgery, are at a higher risk of 1-year mortality. Doctors should pay more attention to these vulnerable patients, and a surgical delay greater than 14 days should be avoided.

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Section: Introductionmentioning

confidence: 99%

One-year mortality risk in older individuals with femoral intertrochanteric fracture: a tertiary center in China

Hao,

Wang,

Chen

et al. 2024

BMC Geriatr

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“…In Spain, its incidence is approximately 104 cases per 100,000 inhabitants, and this number is anticipated to rise in the forthcoming years due to the aging population, thereby escalating the prevalence of osteoporosis and the risk of fracture among individuals over 80 years [1]. This age cohort is particularly susceptible to postoperative medical and surgical complications, including pneumonia, delirium, heart failure, and urinary tract infections [2,3].…”

Section: Introductionmentioning

confidence: 99%

Respiratory Complications Are the Main Predictors of 1-Year Mortality in Patients with Hip Fractures: The Results from the Alzira Retrospective Cohort Study

García-Tercero,

Belenguer-Varea,

Villalon-Ruibio

et al. 2024

Geriatrics

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Introduction: Hip fractures pose a significant challenge for older individuals given their high incidence and one-year mortality rate. The objective of this study was to identify the primary predictors of one-year mortality in older adults hospitalized for hip fractures. Methods: We conducted a retrospective cohort study involving adults aged 70 years or older who were admitted to the hospital for fragility hip fractures between 1 January 2014 and 31 December 2021. A total of 3229 patients were recruited, with 846 (26.2%) experiencing one-year mortality. Results: Respiratory complications (HR 2.42, 95%CI 1.42–4.14; p = 0.001) were the most significant predictors of one-year mortality, followed by hospital readmission (HR 1.96, 95%CI 1.66–2.32; p < 0.001), the male sex (HR 1.88, 95%CI 1.46–2.32; p < 0.001), cardiac complications (HR 1.88, 95%CI 1.46–2.32; p < 0.001), and a diagnosis of dementia at admission (HR 1.37, 95%CI 1.13–1.66; p = 0.001). The Charlson Index and the American Society of Anesthesiologists physical status classification system also significantly increased the mortality risk. Conversely, higher hemoglobin levels at admission and elevated albumin at discharge significantly reduced the mortality risk. Conclusions: The one-year mortality rate is substantial in older adults with hip fractures who are admitted to an orthogeriatric unit. The appropriate management of anemia, nutritional disorders, and comorbidity at admission and during the follow-up could potentially mitigate long-term mortality after hip fractures.

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Effect of Suanzaoren on Perioperative Analgesia, Hemodynamics and Postoperative Delirium

Zhao,

Chen,

Qin

et al. 2024

j biobased mat bioenergy

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Hip fracture is not only accompanied by severe pain, but also impair body tissue and organ functions in patients, particularly in elderly individuals who have reduced tolerance and are prone to organ damage after experiencing a hip fracture. Surgery is the primary clinical approach for treating hip fractures. However, both the fracture trauma and surgical procedure can result in significant pain during the perioperative period, leading to abnormal hemodynamic fluctuations and an increased risk of postoperative delirium. Therefore, it is crucial to select an appropriate intervention method to facilitate the postoperative rehabilitation of hip fracture patients. Traditional Chinese Medicine (TCM) acknowledges that surgery will have different degrees of impact on muscles and bones, Qi and blood. Suanzaoren Decoction contains suanzaoren, anemarrhena asphodeloides, ligusticum chuanxiong and other TCM. The effective components of these TCM, such as spinosin, sarsasapogenin, and tetramethylpyrazine, have been proved to have analgesic effects. This study demonstrates, through clinical trials, that Suanzaoren Decoction exerts a positive influence on promoting the postoperative rehabilitation of hip fracture patients by reducing postoperative pain, stabilizing hemodynamic indexes, improving inflammatory state, and shortening the duration of postoperative delirium (all P <0.05). The fact that Suanzaoren Decoction can effectively promote the postoperative rehabilitation of hip fracture patients may be related to the anti-inflammatory, analgesic and neuroprotective effects of the effective ingredients in the prescription, such as spinosin, sarsasapogenin and tetramethylpyrazine. Therefore, this study believes that Suanzaoren Decoction+ERAS intervention program represents an optimal approach for hip fracture surgery patients within the perioperative period.

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Risk factors for mortality after hip fracture surgery in Japan using the National Database of Health Insurance Claims and Specific Health Checkups of Japan

Cited by 6 publications

References 28 publications

One-year mortality risk in older individuals with femoral intertrochanteric fracture: a tertiary center in China

One-year mortality risk in older individuals with femoral intertrochanteric fracture: a tertiary center in China

Respiratory Complications Are the Main Predictors of 1-Year Mortality in Patients with Hip Fractures: The Results from the Alzira Retrospective Cohort Study

Effect of Suanzaoren on Perioperative Analgesia, Hemodynamics and Postoperative Delirium

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