Hip Fracture Surgery and Survival in Centenarians

Mazzola, Paolo; Rea, Federico; Merlino, Luca; Bellelli, Giuseppe; Dubner, Lauren; Corrao, Giovanni; Pasinetti, Giulio Maria; Annoni, Giorgio

doi:10.1093/gerona/glw016

Cited by 13 publications

(9 citation statements)

References 23 publications

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“…The hazard function in the study by Mazzola et al showed that the greatest risk was 3-4 months postoperatively with an approximation of the trends afterwards in line with previous literature stating that the greatest risk for mortality is in the first 3 months after surgery (Haentjens et al 2010). In the study by Mazzola et al (2016), 81% of the centenarians had a Charlson Comorbidity Index of 0 compared with 68% in our study. In a single-center study from Spain on risk factors and mortality rates comparing 33 centenarians with 99 nonagenarian controls (Barcelo et al 2018), they found that these groups had similar in-hospital outcomes but the centenarians had more postoperative complications.…”

Section: Comparison With Literaturesupporting

confidence: 90%

“…The centenarian age group in Italy has the highest rate of increase in numbers of the geriatric population. In a cohort of 7,830 centenarians collected between 2004 and 2011, the number of patients who suffered hip fractures was 259, giving an incidence rate of 23/1,000 per year in contrast to the overall incidence rate of 47/1,000 in our study (Mazzola et al 2016). This is in line with a previous study where the incidence rates have been found to be much higher in Scandinavia than in the rest of Western Europe (Dhanwal et al 2011).…”

Section: Comparison With Literaturesupporting

confidence: 89%

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

et al. 2019

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Section: Comparison With Literaturesupporting

confidence: 90%

Section: Comparison With Literaturesupporting

confidence: 89%

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

et al. 2019

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“…The incidence for hip fractures in the ≥100-year-old population has been estimated to be 23.1 per 1000 individuals per year (2.3% per year), whereas our study found a fracture incidence of 1.9% per year among our population of very elderly individuals. 14 This indicates that our population of nonagenarian and older Arkansans may have characteristics that contributed to the preservation of bone health even into extreme old age.…”

Section: Discussionmentioning

confidence: 89%

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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“…Twelve of these studies reported survival rates for at least five years for all patients. There were 20 studies that limited their analysis to patients in a subset of the greater-than-65 patient population, eg, octagenarians [ 7 ], nonagenarians [ 8 , 9 ], or centenarians [ 10 ]. Among the 43 studies, 26 were conducted on populations in Europe, seven in the United States, eight in east Asia, one in Israel [ 11 ], and one in New Zealand [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

Predicting life expectancy after geriatric hip fracture: A systematic review

Lee

Weintraub

et al. 2021

PLoS ONE

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Background Displaced femoral neck fractures in geriatric patients are typically treated with either hemiarthroplasty or total hip arthroplasty. The choice between hemiarthroplasty and total hip arthroplasty requires a good estimate of the patient’s life expectancy, as the recent HEALTH trial suggests that the benefits of the two operations do not diverge, if at all, until the second year post-operatively. A systematic review was this performed to determine if there sufficient information in the medical literature to estimate a patient’s life expectancy beyond two years and to identify those patient variables affecting survival of that duration. Methods Pubmed, Embase, and Cochrane databases were queried for articles reporting survival data for at least two years post-operatively for at least 100 patients, age 65 or greater, treated surgically for an isolated hip fracture. A final set of 43 papers was created. The methods section of all selected papers was then reviewed to determine which variables were collected in the studies and the results section was reviewed to note whether an effect was reported for all collected variables. Results There were 43 eligible studies with 25 unique variables identified. Only age, gender, comorbidities, the presence of dementia and fracture type were collected in a majority of studies, and within that, only age and gender were reported in a majority of the results. Most (15/ 25) variables were reported in 5 or fewer of the studies. Discussion There are important deficiencies in the literature precluding the evidence-based estimation of 2 year life expectancy. Because the ostensible advantages of total hip arthroplasty are reaped only by those who survive two years or more, there is a need for additional data collection, analysis and reporting regarding survival after geriatric hip fracture.

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Hip Fracture Surgery and Survival in Centenarians

Abstract: Survival analysis exhibited an excess mortality in the first 3 months among HF cohort members, but not beyond this period. Every effort to counteract HF is warranted, including prevention of falls and high quality of care, especially in the early postsurgical time.

Cited by 13 publications

References 23 publications

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

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

Does Superior Bone Health Promote a Longer Lifespan?

Predicting life expectancy after geriatric hip fracture: A systematic review

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