Functionality, comorbidity, complication & surgery of hip fracture in older adults by age distribution

Abstract

SUMMARY BACKGROUND Hip fractures may be the greatest complication secondary to osteoporotic disorder. The objective of this study was to determine the influence of age distribution in the functionality, comorbidity, complications and surgical features of older adults with hip fractures. METHODS A prospective cohort study was carried out from 2013 to 2014. A sample of 557 adults over 75 years old with osteoporotic hip fractures was recruited from the Orthogeriatric Unit of the León University Hospital (Spain). Age distributions of 75–84, 85–90 and >90 years old were considered. Firstly, sociodemographic data, fracture type and hospital staying days were collected. Secondly, baseline functionality (Barthel index), ambulation, cognitive impairment and comorbidities were described. Thirdly, surgical intervention, urgency, type, American Association of Anesthesiologists (ASA) scores, non-surgical cause, and baseline pharmacologic treatments were determined. Finally, complications and features at hospital discharge were observed. RESULTS The age ranges did not show any statistically-significant differences (P<.05; R2=.000–.005) for gender, fracture type, or number of hospital staying days. Statistically-significant differences (P<.05; R2=.011–.247) between age groups were observed for Barthel index, cognitive impairment, dementia, osteoporosis, Parkinson’s disease, aortic stenosis, surgery type, ASA–score, non-surgical cause, benzodiazepines, antidementia, anti-osteoporosis, insulin, pharmacologic treatments, renal function alteration, heart failure, destination and ambulation features. All other measurements did not show statistically-significant differences (P>.05; R2=.000–.010). CONCLUSION Age distributions greater than 75 years old may determine the functionality, comorbidities, surgical features, baseline pharmacologic treatments, complications and features at hospital discharge for older adults who suffer a hip fracture.

Pre-Existing Disability and Its Risk of Fragility Hip Fracture in Older Adults

“…Our findings indicate that the risk of hip fracture increases with age, a result that is consistent with those of previous studies [1,29,32] among both disabled and non-disabled people, though the gradient was steeper among non-disabled individuals. Owing to the strong association between disability rate and age, the association between age and hip fracture was attenuated among disabled people.…”

“…Previous studies also concluded that higher fall incidence and accident rates among individuals with disabilities resulted in elevated incidence of hip fracture. For example, age-related differences in experience of hip fractures induced from the functionality, comorbidities, surgical features, baseline differences by pharmacologic treatments, complications and features at hospital discharge [1]. In addition, the conclusion of previous literature that the cognitive impairment levels were associated with the characteristics, comorbidities, pharmacology, and complications of older adults with hip fracture [2] also supports the importance of the prevention of secondary condition.…”

“…However, the association between disability and hip fracture has long been overlooked, as disability was typically regarded and treated as a complication ensuing from a hip fracture. Although increased hip fracture incidence was detected among individuals with functional disability [1,2,3], a more targeted approach, i.e., one that takes disability type and severity into consideration, is necessary to increase public awareness regarding prevention of hip fracture, and to develop a customized rehabilitation program. Individuals who experience hip fracture utilize more medical services and have higher hospital admission rates, thus incurring higher medical costs during the first year following osteoporotic hip fracture [4] compared to patients who have not experienced fractures.…”

Predictors of Delirium in Octogenarian Patients Hospitalized for a Hip Fracture

“…The fact that the sample in our study had a higher ratio of women to men is not a characteristic of just our study; in general, this proportion is common in both clinical and social research. One possible explanation is that for cultural reasons, women are usually more open to participating in research studies than men and in clinical contexts, it can be explained by the fact that women have a higher life expectancy than men [ 17 ].…”

Good practices in the recovery of ambulation in octogenarian women with hip fractures

“…It is estimated that the average age individuals who suffer from hip fractures (HF) is 81.4 ± 8.1 years, and they are more frequent in women than in men 1,2 . At the same time, it is evident that this type of fracture causes a high comorbidity rate, with an average of 3.7 comorbidities per patient, with a high incidence of signs of cognitive deterioration and a state of acute confusion 3,4 .…”