Post-hip fracture rehabilitation outcomes of diabetic and non-diabetic elderly patients

Ben-Joseph, Ronen; luboshitz, Barak; Ayzenfeld, Rachel Heffez; Twito, Orit

doi:10.1080/07853890.2021.2009555

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…This is not surprising due to the additional surveillance and care required of these patients, as diabetes has been shown to increase the risk of mortality after hip fractures. 31,32 Another notable finding of this study was the existence of disparities in the discharge disposition between White and minority patients. While Texas represents 19% of the country's uninsured population, 61% of uninsured Texans are Hispanic, and 16% are Black, in which our analysis included a percentage of uninsured patients.…”

Section: Discussionmentioning

confidence: 70%

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In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures: An Analysis of the Texas Trauma Registry

Martinez,

Quirarte,

Treffalls

et al. 2023

Geriatr Orthop Surg Rehabil

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Background In-hospital mortality and discharge disposition following traumatic hip fractures previously reported in the literature, has mainly focused on a nationwide scale, which may not be reflective of unique populations. Objective Our aim was to characterize demographics, hospital disposition, and associated outcomes for patients with the most common hip fractures. Methods A retrospective study utilizing the Trauma Registry from the Texas Department of State Health Services. Patient demographics, injury characteristics, and outcomes, such as in-hospital mortality, and discharge dispositions, were collected. The data were analyzed via univariate analysis and multivariate regressions. Results There were 17,104 included patients, composed of 45% femoral neck fractures (FN) and 55% intertrochanteric fractures (IT). There were no differences in injury severity score (ISS) (9 ± 1.8) or age (77.4 ± 8 years old) between fracture types. In-hospital mortality risk was low but different among fracture types (intertrochanteric, 1.9% vs femoral neck, 1.3%, P = .004). However, when controlling for age, and ISS, intertrochanteric fractures and Hispanic patients were associated with higher mortality ( P < .001, OR 1.5, 95% CI 1.1-2.0). Uninsured, and Black/African American ( P = .05, OR 1.2, 95% CI 1.1-1.3) and Hispanic ( P < .001, OR 1.2, 95% CI 1.1-1.3) patients were more likely to be discharged home after adjusting for age, ISS, and payment method. Conclusion Regardless of age, severity of the injury or admission hemodynamics, intertrochanteric fractures and Hispanic/Latino patients had an increased risk of in-hospital mortality. Patients who were uninsured, Hispanic, or Black were discharged home rather than to rehabilitation, regardless of age, ISS, or payment method.

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Section: Discussionmentioning

confidence: 70%

“…This is not surprising due to the additional surveillance and care required of these patients, as diabetes has been shown to increase the risk of mortality after hip fractures. 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures: An Analysis of the Texas Trauma Registry

Martinez,

Quirarte,

Treffalls

et al. 2023

Geriatr Orthop Surg Rehabil

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“…Diabetic osteopathy, a severe complication of type 1 diabetes mellitus (T1DM), is often accompanied by low bone mass and increased skeletal fragility [ 1 , 2 ]. Compared to healthy individuals, T1DM patients have a higher risk of bone fractures [ 3 ]. This not only diminishes patients' quality of life but also imposes a significant economic burden.…”

Section: Introductionmentioning

confidence: 99%

FNDC5/irisin ameliorates bone loss of type 1 diabetes by suppressing endoplasmic reticulum stress‑mediated ferroptosis

Dong,

Han,

Gao

et al. 2024

J Orthop Surg Res

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Background Ferroptosis is known to play a crucial role in diabetic osteopathy. However, key genes and molecular mechanisms remain largely unclear. This study aimed to identify a crucial ferroptosis-related differentially expressed gene (FR-DEG) in diabetic osteopathy and investigate its potential mechanism. Methods We identified fibronectin type III domain-containing protein 5 (FNDC5)/irisin as an essential FR-DEG in diabetic osteopathy using the Ferroptosis Database (FerrDb) and GSE189112 dataset. Initially, a diabetic mouse model was induced by intraperitoneal injection of streptozotocin (STZ), followed by intraperitoneal injection of irisin. MC3T3-E1 cells treated with high glucose (HG) were used as an in vitro model. FNDC5 overexpression plasmid was used to explore underlying mechanisms in vitro experiments. Femurs were collected for micro-CT scan, histomorphometry, and immunohistochemical analysis. Peripheral serum was collected for ELISA analysis. Cell viability was assessed using a CCK-8 kit. The levels of glutathione (GSH), malondialdehyde (MDA), iron, reactive oxygen species (ROS), and lipid ROS were detected by the corresponding kits. Mitochondria ultrastructure was observed through transmission electron microscopy (TEM). Finally, mRNA and protein expressions were examined by quantitative real‐time PCR (qRT‐PCR) and western blot analysis. Results The expression of FNDC5 was found to be significantly decreased in both in vivo and in vitro models. Treatment with irisin significantly suppressed ferroptosis and improved bone loss. This was demonstrated by reduced lipid peroxidation and iron overload, increased antioxidant capability, as well as the inhibition of the ferroptosis pathway in bone tissues. Furthermore, in vitro studies demonstrated that FNDC5 overexpression significantly improved HG-induced ferroptosis and promoted osteogenesis. Mechanistic investigations revealed that FNDC5 overexpression mitigated ferroptosis in osteoblasts by inhibiting the eukaryotic initiation factor 2 alpha (eIF2α)/activated transcription factor 4 (ATF4)/C/EBP-homologous protein (CHOP) pathway. Conclusions Collectively, our study uncovered the important role of FNDC5/irisin in regulating ferroptosis of diabetic osteopathy, which might be a potential therapeutic target.

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Research Progress on Risk Factors for Com-mon Perioperative Complications of Senile Hip Fracture

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2023

ACM

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Post-hip fracture rehabilitation outcomes of diabetic and non-diabetic elderly patients

Cited by 3 publications

References 29 publications

In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures: An Analysis of the Texas Trauma Registry

In-Hospital Mortality Risk and Discharge Disposition Following Hip Fractures: An Analysis of the Texas Trauma Registry

FNDC5/irisin ameliorates bone loss of type 1 diabetes by suppressing endoplasmic reticulum stress‑mediated ferroptosis

Research Progress on Risk Factors for Com-mon Perioperative Complications of Senile Hip Fracture

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