Centenarian hip fracture patients: a nationwide population-based cohort study of 507 patients

Mosfeldt, Mathias; Madsen, Christian; Lauritzen, Jes Bruun; Jørgensen, Henrik L.

doi:10.1080/17453674.2019.1602386

Cited by 12 publications

(6 citation statements)

References 18 publications

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“…In our analysis, we observed little change in mortality following a hip fracture between 2007 and 2015. Similarly a study of centenarians with hip fracture found no difference in mortality between 1990 and 2012 . A more recent community‐based study from Kaiser Permanente (mean age 81 years) reported that 1 year mortality following hip fracture was 21% .…”

Section: Discussionmentioning

confidence: 96%

Secular Trends in the Incidence of Hip Fracture Among Nursing Home Residents

Berry

Daiello

Lee

et al. 2020

Journal of Bone and Mineral Research

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A recent study suggested a decline in the incidence of hip fracture among US women between 2002 and 2012, followed by a leveling in the incidence rate from 2013 to 2015. Newly admitted nursing home residents are particularly vulnerable to hip fracture, and it is unclear whether that trend is observed in this high risk group. The purpose of our study was to describe trends in hip fracture rates and postfracture mortality among 2.6 million newly admitted US nursing home residents from 2007 to 2015, and to examine whether these trends could be explained by differences in resident characteristics. Medicare claims data were linked with the Minimum Data Set (MDS), a clinical assessment performed quarterly on all nursing home residents. In each year (2007–2015), we identified newly admitted long‐stay (ie, 100 days in the same facility) nursing home residents. Hip fracture was defined using Medicare Part A diagnostic codes. Follow‐up time was calculated from the index date until the first event of hospitalized hip fracture, Medicare disenrollment, death, or until 1 year. Poisson regression was used to adjust rates of hip fracture for age and sex. The number of newly admitted nursing home residents ranged from 324,508 in 2007 to 257,350 in 2015. Although mean age remained similar (83 years), residents were more functionally dependent over time. There was a small absolute decrease in the incidence rate of hip fracture between 2007 (3.32/100 person‐years) and 2013 (2.82/100 person‐years), with an increase again in 2015 (3.03/100 person‐years). Adjusting for patient characteristics somewhat attenuated these trends. One‐year mortality was high following fracture in all years (42.6% in 2007, 42.1% in 2014). In summary, we observed a recent slight rise in the incidence rates of hip fracture among nursing home residents that was at least partially explained by differences in resident characteristics over time. © 2020 American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 96%

Secular Trends in the Incidence of Hip Fracture Among Nursing Home Residents

Berry

Daiello

Lee

et al. 2020

Journal of Bone and Mineral Research

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“…3,4 Studies on hip fractures in centenarians are limited in number of patients and show contradictory results. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Differences have been described in relation to the type of fracture, [2][3][4][5][6][7][8] the relationship between time to surgery and outcomes 5 and the risk of complications during hospitalisation. 9 Discrepancies have also been published regarding short and long-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…9 Discrepancies have also been published regarding short and long-term outcomes. [6][7][8]11,12 A recent study including more than 4000 centenarians with hip fracture focused exclusively on complications during hospitalization, but did not include outcomes related to mortality or functional status in the first month after the fracture. 10 Considering the above, the primary objective of this study was to describe the clinical characteristics, management, and outcomes of centenarians admitted with fragility hip fracture and to compare them with those observed in patients aged 75 to 79, 80 to 89 (octogenarians) and 90 to 99 years old (nonagenarians) using data from the Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera, RNFC).…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Demographic Characteristics of Centenarians versus Other Age Groups Over 75 Years with Hip Fractures

Boixareu¹,

Ojeda-Thies²,

Valtueña³

et al. 2023

CIA

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Objective The primary objective was to describe the clinical characteristics, management, and outcomes of centenarians with fragility hip fracture and compare them to other age groups. The secondary objective was to determine the variables associated with length of stay, in-hospital mortality and 30-day mortality. Materials and Methods This is a secondary analysis of the Spanish National Hip Fracture Registry. We included patients ≥75 years admitted for fragility hip fractures in 86 Spanish hospitals between 2017 and 2019, dividing the sample into four age groups. The variables studied were baseline characteristics, type of fracture, management, length of stay, in-hospital mortality and 30-day mortality. Results We included 25,938 patients (2888 were 75–79 years old; 14,762 octogenarians; 8,035 nonagenarians and 253 centenarians). Of the centenarians, 83% were women, 33% had severe dementia, 9% had severe dependency and 36% lived in residential care homes. Six out of ten had intertrochanteric fracture. Length of hospital stay was 8.6 days; in-hospital mortality was 10.3% and 30-day mortality 20.9%. Older age groups had more women, severe functional dependency, severe dementia, intertrochanteric fracture, living in care facilities and being discharged to nursing care. They had less frequent early mobilization, osteoporosis treatment and discharge to rehabilitation units. In-hospital and 30-day mortality were higher with increasing age. In centenarians, time to surgery >48 hours was independently associated with length of stay (correlation coefficient 3.99 [95% CI: 2.35–5.64; p<0.001]) and anaesthetic risk, based on an ASA score of V, was related to 30-day mortality (ASA score II [OR 0.25, 95% CI: 0.09–0.70; p=0.009] and ASA score III [OR 0.43, 95% CI: 0.19–0.96; p=0.039]). Conclusion Centenarians had different clinical characteristics, management and outcomes. Although centenarians had worse outcomes, nearly 4 out of 5 centenarians were alive one month after surgery.

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“…7 .These very elderly individuals tend to display exceptional health throughout their life before experiencing a sudden rapid decline at the end. 8,9 The certified causes of death among this demographic group are most likely to be associated with “acute decline” due to frailty and pneumonia, conditions which are often the result of hospitalization. 10,11 It is the unique ability of these very old to defer experiencing debilitating health issues until their 80s and 90s, which make them an important population to study for further understanding the aging process.…”

Section: Introductionmentioning

confidence: 99%

Does Superior Bone Health Promote a Longer Lifespan?

Dayer

Mears²,

Pangle

et al. 2021

Geriatr Orthop Surg Rehabil

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Introduction Public health achievements throughout the last century have resulted in a steady increase in life expectancy. An emergent subset has distinguished themselves, living well beyond the ninth decade by avoiding or delaying the onset of most age-related diseases, including bone diseases and fractures. In this study, we evaluated the bone health of the oldest community-dwelling individuals living in rural Arkansas. Methods 299 patients aged ≥90 years were retrospectively reviewed for recorded fractures within 12 years prior to the investigation period. Records were also examined for medications and test results pertinent to bone health, including thyroid stimulating hormone, vitamin D levels, hematocrit, hemoglobin, body mass index, and bone densitometric values. Results 68 patients (23%) had at least one fracture documented, and 15 had >1 fracture. 40% of patients with fractures had osteoporosis and 28% had osteopenia, respectively. 232 patients (78%) had no documented fractures, and of these, only 18% had osteoporosis and 16% had osteopenia. No significant clinical markers were found among the very old to explain the relatively low occurrence of fractures. Conclusions Patients over 90 years of age had an overall low prevalence of fractures and relative preservation of bone health, suggesting a preserved bone molecular profile in these individuals. Epigenetic factors and activity levels might also have favorably affected bone health. The low percentage of osteoporosis and fractures likely reduced the morbidity and mortality in this population, potentially contributing to their overall longevity.

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Centenarian hip fracture patients: a nationwide population-based cohort study of 507 patients

Cited by 12 publications

References 18 publications

Secular Trends in the Incidence of Hip Fracture Among Nursing Home Residents

Secular Trends in the Incidence of Hip Fracture Among Nursing Home Residents

Clinical and Demographic Characteristics of Centenarians versus Other Age Groups Over 75 Years with Hip Fractures

Does Superior Bone Health Promote a Longer Lifespan?

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