Mortality rates and risk factors after low-trauma hip fracture in the largest university center in Romania

Dobre, Ramona; Niculescu, D; Cîrstoiu, Cătălin; Popescu, Ionel Cătălin; Poiană, Cătălina

doi:10.1007/s11657-021-00934-5

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…Artificial joint replacement has been the preferred treatment for advanced joint disease and some traumatic periarticular injuries, which can not only relieve pain and limb dysfunction but also reduce mortality. 1 At present, the artificial joint materials used in the clinical setting mainly include metals, polymer composite materials, etc., but they all inevitably generate particles due to prosthesis friction. Aseptic osteolysis and joint loosening around the joints caused by these byproducts are the main reasons for late revision surgery, which greatly affects the lifespan and therapeutic effect of the joints.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bimetallic Metal–Organic Framework for Mitigating Aseptic Osteolysis

Pan

Miao

Deng

et al. 2023

ACS Appl. Mater. Interfaces

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The disability rate of joint diseases can be reduced by the use of artificial joints, but joint loosening at a late state limits the lifespan and surgical efficacy of the joints. Wear particles can be recognized by macrophages and induce cells to produce reactive oxygen species (ROS) and inflammatory factors, causing persistent inflammation and decreased osteogenic activity, which ultimately leads to loosening of joint prostheses. Here, the platinum (Pt) nanozymes with excellent ROS scavenging and anti-inflammatory capabilities were encapsulated in zinc imidazolium zeolite framework-8 (ZIF-8), and then the osteogenic active element lanthanum (La) was introduced through ion exchange to finally construct a bimetallic metal−organic framework (Pt@ZIF-8@ La). In vitro and in vivo experiments demonstrated that this multifunctional nanoplatform possessed the functions of efficient scavenging of ROS, immune regulation, and promotion of osteogenic differentiation. Meanwhile, the mechanism is explored that Pt@ZIF-8@La can also promote osteogenic mineralization by upregulating the ratio of the osteoprotegerin (OPG)/receptor activator of the NF-κB ligand (RANKL), which can achieve a synergistic therapeutic effect of immunomodulation and osteogenesis, thereby realizing the purpose of relieving aseptic osteolysis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bimetallic Metal–Organic Framework for Mitigating Aseptic Osteolysis

Pan

Miao

Deng

et al. 2023

ACS Appl. Mater. Interfaces

View full text Add to dashboard Cite

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“…Hip fractures, in particular, carry high rates of morbidity and mortality in the geriatric population [ 3 ]. Associated factors for poor outcomes in these patients include age, male gender, the presence of comorbidities, delayed time to surgery, and baseline ambulatory status [ 4 , 5 ]. As age, and to a certain degree, comorbidities are non-modifiable risk factors, it is important to consider factors that can be modified to lower a patient’s risk.…”

Section: Introductionmentioning

confidence: 99%

The Role of Smoking and Body Mass Index in Mortality Risk Assessment for Geriatric Hip Fracture Patients

Meltzer-Bruhn¹,

Esper²,

Herbosa³

et al. 2022

Cureus

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BackgroundSmoking, obesity, and being below a healthy body weight are known to increase all-cause mortality rates and are considered modifiable risk factors. The purpose of this study is to assess whether adding these risk factors to a validated geriatric inpatient mortality risk tool will improve the predictive capacity for hip fracture patients. We hypothesize that the predictive capacity of the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) tool will improve. MethodologyBetween October 2014 and August 2021, 2,421 patients >55-years-old treated for hip fractures caused by low-energy mechanisms were analyzed for demographics, injury details, hospital quality measures, and mortality. Smoking status was recorded as a current every-day smoker, former smoker, or never smoker. Smokers (current and former) were compared to non-smokers (never smokers). Body mass index (BMI) was defined as underweight (<18.5 kg/m 2 ), healthy weight (18.5-24.9 kg/m 2 ), overweight (25.0-24.9 kg/m 2 ), or obese (>30 kg/m 2 ). The baseline STTGMA tool for hip fractures (STTGMAHIP_FX_SCORE) was modified to include patients' BMI and smoking status (STTGMA_MODIFIABLE), and new mortality risk scores were calculated. Each model's predictive ability was compared using DeLong's test by analyzing the area under the receiver operating curves (AUROCs). Comparative analyses were conducted on each risk quartile. ResultsA comparison of smokers versus non-smokers demonstrated that smokers experienced higher rates of inpatient (p = 0.025) and 30-day (p = 0.048) mortality, myocardial infarction (p < 0.01), acute respiratory failure (p < 0.01), and a longer length of stay (p = 0.014). Comparison among BMI cohorts demonstrated that underweight patients experienced higher rates of pneumonia (p = 0.033), decubitus ulcers (p = 0.046), and the need for an intensive care unit (ICU) (p < 0.01). AUROC comparison demonstrated that STTGMA_MODIFIABLE significantly improved the predictive capacity for inpatient mortality compared to STTGMAHIP_FX_SCORE (0.792 vs. 0.672, p = 0.0445). Quartile stratification demonstrated the highest risk cohort had a longer length of stay (p < 0.01), higher rates of inpatient (p < 0.01) and 30-day mortality (p < 0.01), and need for an ICU (p < 0.01) compared to the minimal risk cohort. Patients in the lowest risk quartile were most likely to be discharged home (p < 0.01). ConclusionsSmoking, obesity, and being below a healthy body weight increase the risk of perioperative complications and poor outcomes. Including smoking and BMI improves the STTGMAHIP_FX_SCORE tool to predict mortality and risk stratify patient outcomes. Because smoking, obesity, and being below a healthy body weight are modifiable patient factors, providers can counsel patients and implement lifestyle changes to potentially decrease their risk of longer-term poor outcomes, especially in the setting of another fracture. For patients who are former smokers, providers can use this information to encourage continued restraint and healthy choices.

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“…However, it has also been found that the 1-year mortality rate after hip fracture surgery is as high as 20% or even 30% ( 2 , 3 ). In this regard, many researchers have studied the factors influencing the risk of death after hip fracture in the general older adults, but there are fewer prognostic studies related to critically ill patients with hip fracture ( 4 , 5 ). To fill this academic gap, the aim of this study is to analyze the incidence of 1-year mortality after hip fracture surgery in critically ill older adults.…”

Section: Introductionmentioning

confidence: 99%

Identification of risk factors for 1-year mortality among critically ill older adults with hip fractures surgery: A single medical center retrospective study

et al. 2022

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AimThe purpose of this study was to analyze the potential risk factors for mortality 1 year after hip fracture surgery in critically ill older adults.MethodsWe reviewed 591 critically ill older adults who underwent hip surgery at our institution from January 2018 to April 2021. We collected baseline demographics, clinical information, and 1-year survival status of the sample patients by means of medical record systems and follow-up phone calls. Patients were divided into survival and mortality groups based on survival within 1 year after surgery.ResultsBased on the results of the 1-year postoperative follow-up of patients, we obtained 117 cases in the death group and 474 cases in the survival group, and this led to a 1-year mortality rate of 19.8% (117/591) after hip fracture in critically ill older adults at our hospital. The risk factors that influenced the 1-year postoperative mortality were identified as advanced age (HR:1.04, 95%, 1.01–1.06), preoperative arrhythmia (HR: 1.95, 95%, 1.26–2.70), high level of NLR (HR:1.03, 95%, 1.01–1.06), respiratory failure (HR: 2.63, 95%, 1.32–5.23), and acute cardiovascular failure. 5.23) and acute cardiovascular events (HR: 1.65, 95%, 1.05–2.59).ConclusionAdvanced age, preoperative arrhythmias, high levels of NLR, postoperative respiratory failure, and acute cardiovascular events were independent risk factors for survival of critically ill older adults with hip fracture at 1 year after surgery. Therefore, laboratory tests such as high levels of preoperative NLR can be an important indicator of patient prognosis.

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Mortality rates and risk factors after low-trauma hip fracture in the largest university center in Romania

Cited by 6 publications

References 31 publications

Bimetallic Metal–Organic Framework for Mitigating Aseptic Osteolysis

Bimetallic Metal–Organic Framework for Mitigating Aseptic Osteolysis

The Role of Smoking and Body Mass Index in Mortality Risk Assessment for Geriatric Hip Fracture Patients

Identification of risk factors for 1-year mortality among critically ill older adults with hip fractures surgery: A single medical center retrospective study

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