Risk Factors and Trends Associated With Mortality Among Adults With Hip Fracture in Singapore

Abstract

IMPORTANCE Examining trends in mortality following hip fracture and its associated factors is important for population health surveillance and for developing preventive interventions. OBJECTIVE To examine temporal trends in, and risk factors associated with, mortality following hip fracture over 18 years in Singapore. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-based cohort study included men and women aged 50 years and older admitted to Singapore hospitals for first hip fracture identified and followed up from 2000 to 2017. Demographic information, fracture type, and Charlson Comorbidity Index (CCI) score were retrieved from nationwide claims data, and mortality data were from the National Death Registry. Data were analyzed from August 2018 to December 2019. MAIN OUTCOMES AND MEASURES Adjusted hazard ratios (aHRs) and their 95% confidence intervals were estimated using Cox proportional hazards regression. Kaplan-Meier life table methods were used to calculate survival following the hip fracture on a cohort basis. The crude survival over time since fracture was compared by sex, age group, ethnicity, CCI, and fracture type. Standardized mortality ratios (SMRs) were calculated using all-cause mortality obtained from Singapore population life tables. RESULTS Among 36 082 first inpatient admissions for hip fractures (mean [SD] patient age, 78.2 [10.1] years; 24 902 [69.0%] female; 30 348 [84.1%] Chinese, 2863 [7.9%] Malay, 1778 [4.9%] Indian, and 1093 [3.0%] other ethnicity), elevated rates of mortality were observed for male sex

Functional Outcome And Mortality Assessment Following Proximal Femoral Nailing In Inter Trochanteric Fracture

“…Most of the deaths reported at 2 years follow up were associated with co-morbidities and higher ASA grade, which is in line with other studies (Hommel et al, 2008) [ Table 9]. Young E-L et al, in his study "Risk Factors and Trends Associated with Mortality Among Adults with Hip Fracture in Singapore" followed 36082 patients for 18 years after hip fractures and con-cluded that Malay ethnicity, older age, male sex, prefracture co-morbidity, and trochanteric fractures were independently associated with increased risk of death, identifying population groups that could be targeted for intervention strategies (Yong et al, 2020). These results are in line with our study in which 8 deaths reported at the end of 3 years follow up were associated with higher age (>70 years), male sex, pre-fracture co-morbidities and higher ASA grades [ Table 8].…”

Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York City Perspective

“…Male sex, older age, and higher CCI have all been associated with increased mortality after geriatric hip fracture. [18][19][20] So, it was not surprising that our mortality rate was also male dominant. This may be related to the predominance of males affected by In this cohort of patients, C+ and Cs patients experienced a greater overall major complication rate, including an increase in complications such as sepsis, pneumonia, acute respiratory failure, cardiac arrest, and inpatient mortality.…”

External validation of a clinical risk score to predict hospital admission and in-hospital mortality in COVID-19 patients

“…The variables constituting the tool have been reported as risk factors for severe COVID-19 illness or mortality, are constituents of other well validated prognostic tools such as the Charlson Comorbidity Index (CCI), or are mortality predictors for other respiratory illnesses [26][27][28][29][30][31][32][33][34][35]. Older age in particular heralds worse outcomes in COVID-19 patients in an incremental [26,30,32,34,35].…”