Single-centre study of hip fractures in Prague, Czech Republic, 1997–2007

Skála-Rosenbaum, J; Bartoníček, Jan; Říha, Daniel; Waldauf, Petr; Džupa, Valér

doi:10.1007/s00264-010-0984-x

Cited by 18 publications

(6 citation statements)

References 45 publications

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“…Mean age, the male to female ratio and fracture distribution of our series were comparable to a large cohort study of 3,683 hip fracture patients [17]. Another large series (3,240 patients) of Deakin et al found a comparable mean age and percentage of patients living in their own home prior to admission [8].…”

Section: Discussionsupporting

confidence: 83%

Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Vochteloo

Tuinebreijer

Maier

et al. 2012

International Orthopaedics (SICOT)

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PurposeThis paper reports on the development and validity of a new instrument, called the discharge of hip fracture patients score (DHP), that predicts at admission the discharge location in patients living in their own home prior to hip fracture surgery.MethodsA total of 310 patients aged 50 years and above were included. Risk factors for discharge to an alternative location (DAL) were analysed with a multivariable regression analysis taking the admission variables into account with different weights based on the estimates. The score ranged from 0–100 points. The cut-off point for DAL was calculated using a ROC analysis. Reliability of the DHP was evaluated.ResultsRisk factors for DAL were higher age, female gender, dementia, absence of a partner and a limited level of mobility. The cut-off point was set at 30 points, with a sensitivity of 83.8%, a specificity of 64.7% and positive predictive value of 79.2%.ConclusionThe DHP is a valid, simple and short instrument to be used at admission to predict discharge location of hip fracture patients.

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Section: Discussionsupporting

confidence: 83%

Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Vochteloo

Tuinebreijer

Maier

et al. 2012

International Orthopaedics (SICOT)

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“…A total of 1,130 patients were identified, and 455 met the eligibility requirements for the study population (Table II). Three hundred and eighteen (69.9%) of the patients were female and 137 (30.1%) were male, which is comparable with male-to-female ratios reported in the literature 3 , 27 . The median age was 82.0 years (range, 60 to 99 years), and the median body mass index (BMI) was 23.8 kg/m 2 (range, 13.3 to 63.7 kg/m 2 ).…”

Section: Methodssupporting

confidence: 85%

Association of Brain Natriuretic Peptide Levels at Time of Injury with Morbidity and Mortality in Patients with Surgically Treated Hip Fractures

et al. 2023

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Background: An elevated brain natriuretic peptide (BNP) level has been shown to be associated with mortality and cardiac events in cardiac surgery, but its utility in the prediction of morbidity and mortality in hip fracture surgery is unknown. The primary aim of this study was to determine if there is a difference in BNP level at the time of injury between patients who do and do not develop complications after hip fracture surgery. The secondary aim was to determine if there is a predictive relationship between complications associated with the initial BNP level and mortality. Methods: A retrospective chart review of 455 hip fractures in patients ≥60 years old that were operatively treated between February 2014 and July 2018 was performed. Patients were included if they had a BNP level within 48 hours after injury (BNP i ). Specific perioperative (≤7 days), 30-day, 1-year, and 2-year postoperative complications were recorded. Wilcoxon rank-sum tests were used to determine if higher BNP i values were associated with greater morbidity. The complications associated with higher BNP i values were further analyzed to assess if they were predictive of mortality, using univariate and multivariable analyses. Results: Higher BNP i was significantly associated with greater morbidity at all postoperative time points and with higher mortality at 1 and 2 years postoperatively. Furthermore, several complications including cardiac failure or exacerbation and altered mental status were associated with mortality at all time points in univariate analysis and at many time points in multivariable analysis. Conclusions: Patients with higher BNP i levels were more likely to develop complications up to 1 year postoperatively, and several of these complications were associated with increased mortality. Future studies to determine if delaying surgery until BNP levels are normalized or lowered may help guide management, and may be useful in determining the need for further medical optimization. Future studies aimed at defining a threshold BNP value at the time of injury may also help in better managing patients preoperatively. Level of Evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

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“…Regarding the ratio between pertrochanteric and femoral neck fractures of the femur, Smektala et al 34 showed an almost equal distribution between femoral neck (n ¼ 1466) and pertrochanteric (n ¼ 1450) fractures in a retrospective study on 2916 proximal femoral fractures. Ská la-Rosenbaum 35 examined the epidemiological data of 3683 patients with hip fractures between 1997 and 2007. In this study trochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all proximal femoral fractures.…”

Section: Discussionmentioning

confidence: 99%

DXA and pQCT predict pertrochanteric and not femoral neck fracture load in a human side‐impact fracture model

Gebauer

Stark²,

Vettorazzi

et al. 2013

Journal Orthopaedic Research

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The validity of dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) measurements as predictors of pertrochanteric and femoral neck fracture loads was compared in an experimental simulation of a fall on the greater trochanter. 65 proximal femora were harvested from patients at autopsy. All specimens were scanned with use of DXA for areal bone mineral density and pQCT for volumetric densities at selected sites of the proximal femur. A three-point bending test simulating a side-impact was performed to determine fracture load and resulted in 16 femoral neck and 49 pertrochanteric fractures. Regression analysis revealed that DXA BMD trochanter was the best variable at predicting fracture load of pertrochanteric fractures with an adjusted R 2 of 0.824 (p < 0.0001). There was no correlation between densitometric parameters and the fracture load of femoral neck fractures. A significant correlation further was found between body weight, height, femoral head diameter, and neck length on the one side and fracture load on the other side, irrespective of the fracture type. Clinically, the DXA BMD trochanter should be favored and integrated routinely as well as biometric and geometric parameters, particularly in elderly people with known osteoporosis at risk for falls. Keywords: osteoporosis; femur fracture; BMD; pQCT; DXA Hip fractures are a cause of significant morbidity and mortality worldwide and are a substantial economic burden.1,2 About 54% of women aged 50 years or older will have an osteoporotic fracture during their lifetime. Furthermore, approximately 4% of the patients older than 50 years with a hip fracture die in the hospital and 24% die within 1-year after the hip fracture. 4 Thus, the prevention of osteoporotic femur fractures is of increased significance to reduce morbidity and mortality on the one hand and socio-economic burden on the other hand.At present, areal bone mineral density (aBMD) as obtained from dual energy X-ray absorptiometry (DXA) is the best established clinical parameter for diagnosis and follow-up of osteoporosis. 5,6 It is widely used as a predictor of fracture risk of the hip although there is considerable overlap in the densitometry measurements of individuals who have fractured and those who have not. 7 In addition, over the past years the measurement of volumetric bone mineral density (vBMD) by peripheral quantitative computed tomography (pQCT) gained more and more interest in the field of basic research. Several ex vivo studies indicate that vBMD measured by pQCT has the highest predictive value for mechanical strength of cancellous bone of the proximal and diaphyseal femur. [8][9][10] In this context, there is little data available comparing the predictive value of areal and volumetric BMD measuring techniques on the mechanical strength of the proximal human femur. Moreover, recent publications comparing the predictive value of different bone density measuring techniques on the femoral fracture strength significantly vary for the me...

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Single-centre study of hip fractures in Prague, Czech Republic, 1997–2007

Cited by 18 publications

References 45 publications

Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Association of Brain Natriuretic Peptide Levels at Time of Injury with Morbidity and Mortality in Patients with Surgically Treated Hip Fractures

DXA and pQCT predict pertrochanteric and not femoral neck fracture load in a human side‐impact fracture model

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