Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older

Finsterwald, Michael; Sidelnikov, Eduard; Orav, E. John; Dawson‐Hughes, Bess; Egli, Andreas; Platz, Andreas; Simmen, Hans‐Peter; Meier, Christoph; Grob, Daniel; Beck, Sacha; Stähelin, Hannes; Bischoff‐Ferrari, Heike A.

doi:10.1007/s00198-013-2513-4

Cited by 29 publications

(19 citation statements)

References 72 publications

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“…ese results are in line with those of previous studies [21,22]. Although diabetes was associated with significantly increased risk of hip fracture, a previous meta-analysis reported that the risk of hip fractures is more pronounced in men with diabetes [10].…”

Section: Discussionsupporting

confidence: 92%

Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients

Tian

Tong

et al. 2020

International Journal of Endocrinology

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Objective. To explore the effect of diabetes on short-term (30 days after fracture) and 1-year outcomes for fragility hip fracture patients. Methods. We conducted a retrospective cohort study involving 161 diabetic hip fracture patients (older than 60 years) and 483 nondiabetic hip fracture patients. Patients were followed up on day 30 and 1 year after fracture. The short-term outcome was complications that occurred within 30 days after hip fracture and length of stay. The 1-year outcomes were postfracture functional outcomes and reduced activity level and mortality rate within 1 year after fracture. The clinical characteristics and outcomes of patients were analyzed. Results. Compared with nondiabetic patients, diabetic patients had a longer length of awaiting surgery (6.0 vs. 5.0 days, P=0.031) and a longer length of total hospital stay (17 vs. 15 days, P<0.001). Furthermore, compared with nondiabetic patients, diabetic patients have higher costs (P=0.011), in addition to being more prone to developing urinary tract infections (6.2% vs. 1.7%, P=0.002) and deep vein thrombosis (4.3% vs. 1.4%, P=0.029) complications. However, at one-year follow-up, no differences in recovery of function and mortality were observed between the two groups. Conclusions. Diabetic patients are at an increased risk of urinary tract infections and deep vein thrombosis complications but have similar recovery of function and 1-year mortality compared to nondiabetic patients.

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Section: Discussionsupporting

confidence: 92%

Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients

Tian

Tong

et al. 2020

International Journal of Endocrinology

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“…In our study, this patient group benefitted greatly from CGA with regard to mortality. Community-dwelling hip fracture patients are generally younger and fitter 29 and therefore may have a better prognosis regardless of the geriatrician’s input. Patients living in long-term residential care are generally in worse health and are thus more likely to have a poorer outcome, 30 and the geriatricians’ principal role is to ensure quality of care toward the end of life.…”

Section: Discussionmentioning

confidence: 99%

The Effect of an In-Hospital Comprehensive Geriatric Assessment on Short-Term Mortality During Orthogeriatric Hip Fracture Program—Which Patients Benefit the Most?

Pajulammi

Pihlajamäki

Luukkaala

et al. 2017

Geriatr Orthop Surg Rehabil

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Aims:To examine the association of patient-related factors with the effect of an in-hospital comprehensive geriatric assessment (CGA) on hip fracture mortality.Methods:Population-based, prospective data were collected on 1425 consecutive hip fracture patients aged ≥65 in a central hospital providing orthogeriatric service. Outcome was mortality at 1 month after hip fracture associated with receiving versus not receiving CGA.Results:Of the patients receiving CGA compared to those who did not, 8.5% versus12.0% had died within 1 month of the hip fracture (P = .028). In the age- and sex-adjusted Cox proportional hazards model, CGA was associated with a decreased risk of 1-month mortality in patients aged 80 to 89 years (hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.29-0.73), females (HR: 0.57, 95% CI: 0.38-0.86), having American Society of Anesthesiologists (ASA) score 1 to 3 (HR: 0.60, 95% CI: 0.37-0.99), taking 4 to 10 daily medications (HR: 0.59, 95% CI: 0.38-0.91), with a diagnosis of memory disorder (HR: 0.50, 95% CI: 0.29-0.88), with an estimated glomerular filtration rate <30 mL/min/1.73m2 (HR: 0.28, 95% CI: 0.10-0.76), or living in an assisted living accommodation (HR: 0.40, 95% CI: 0.21-0.76).Conclusion:Several modifiable and patient-related factors were associated with decreased risk of 1-month mortality when CGA was performed during hospitalization for hip fracture. Between “younger and fitter” and “oldest and frailest,” there is a large group of hip fracture patients whose survival can be improved by in-hospital CGA.

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“…Comorbid conditions, such as hemiplegia and dementia in individuals of an advanced age, and the degree of independence in daily life activities, as well as height, weight, and BMI, are reported to be factors associated with falls and fractures. 2 , 27 , 28 In our study, examinations of the systemic diseases frequently seen among the elderly population revealed that dementia was more frequent and that the kyphosis angle was wider in nursing home patients with dementia than in individuals with dementia who reside in non-nursing home settings.…”

Section: Discussionmentioning

confidence: 45%

“…The fact that the fracture incidence rate increases with age is well known; however, the effect of age on the fracture rate among nursing home residents is not clear. 27 In addition to studies that have established the effects of age on fracture risk, 2 , 27 , 28 there are studies that claim it has no effect. 29 , 30 In our study, the number of vertebral fractures was demonstrated to be positively correlated with age in both groups.…”

Section: Discussionmentioning

confidence: 99%

Analysis of kyphosis, vertebral fracture and bone mineral density measurement in women living in nursing homes

Türk

Şahin

Küçükler

et al. 2018

SMJ

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Objectives:To analyze the relationship between vertebral fracture, degree of kyphosis, and BMD in women living in nursing homes.Methods:This cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation, Hitit University Hospital, Corum, Turkey, between January 2014 and January 2015. Of the 126 female patients who participated in the study, 48 lived in nursing homes (nursing-home-group [NHG]), 78 lived in non-nursing home settings (control-group [CG]). Vertebral fractures were evaluated via the semi-quantitative Genant method. Cases in which a Cobb angle measured 40 degrees or more resulted in a diagnosis of kyphosis.Results:The mean age of participants in the NHG was 77.2±7.6 years and 76.8±6.2 years in the CG (p>0.05). The kyphosis rate in the NHG was found to be higher at 52.1% compared to 27.7% for the CG (p<0.001). In the NHG, 68.7% had osteoporosis, 31.3% had osteopenia; in the CG, 55.2% had osteoporosis, 32% had osteopenia, 12.8% had normal values (p<0.05).The vertebral fracture rate was 37.5% in the NHG and 24.3% in the CG (p>0.05). The Cobb angle had correlation with the number of fractures in both groups (p<0.05).Conclusions:The osteoporosis and kyphosis rates of women living in NHG were higher than those of women living in CG. As kyphosis and the number of fractures are correlated, it is important to analyze kyphosis in women residing in NHG.

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Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older

Abstract: We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

Cited by 29 publications

References 72 publications

Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients

Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients

The Effect of an In-Hospital Comprehensive Geriatric Assessment on Short-Term Mortality During Orthogeriatric Hip Fracture Program—Which Patients Benefit the Most?

Analysis of kyphosis, vertebral fracture and bone mineral density measurement in women living in nursing homes

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