The impact of hip fracture on mortality in Estonia: a retrospective population-based cohort study

Jürisson, Mikk; Raag, Mait; Kallikorm, Riina; Lember, Margus; Uusküla, Anneli

doi:10.1186/s12891-017-1606-1

Cited by 15 publications

(14 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subsequently the excess sex-related differences in survival following hip fracture surgery follow a similar trends of the sex-related difference in survival of the general population. That men have a higher risk of dying after hip fracture is well known from the literature, and was shown also in an recent study [ 19 ]. It can be debated if this is induced by sex as an isolated variable, or if being male is a surrogate variable for comorbidity, unhealthy lifestyle or other confounders adding to their risk of both hip fracture and death.…”

Section: Discussionmentioning

confidence: 56%

See 1 more Smart Citation

Relative survival following hemi-and total hip arthroplasty for hip fractures in Sweden

Nemes

Lind

Cnudde

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundHip fractures are a common problem in the ageing population. Hip arthroplasty is the common treatment option for displaced intracapsular neck of femur fractures. Even though hip replacements are successful in restoring mobility, reducing pain and diminishing loss of health-related quality of life, the potential impact of a hip fracture on life expectancy as well as the postoperative mortality need consideration. The purpose of this study was to describe the mid-term relative survival rate for a cohort of Swedish patients whom underwent total- or hemiarthroplasty surgery following hip fracture. We also explored whether the survival rate is prosthesis-type specific and influenced by comorbidities, sex, socioeconomic and surgical factors.MethodsUsing prospectively collected information of the Swedish Hip Arthroplasty Register-linked database we identified 43,891 patients operated between 2005 and 2012. Patient- and surgery-specific data in combination with socio-economic data were available for this analysis. We studied relative survival rate and used multivariable modelling with Cox Proportional Hazards Model in Transformed Time.ResultsCompared to the Swedish general population the baseline excess hazard was very high in the first half year after the operation, thereafter the excess hazard decreased but remained non-negligible through the 8 years’ follow-up period. The mortality rate of males was higher compared to women. Higher Elixhauser comorbidity index (ECI) was associated with worsening survival. However, patients who had ECI = 0 had higher mortality than patients with ECI =1 the first 420 days post fracture. Patients with a hemiarthroplasty had a worse survival than patients with a total hip arthroplasty. Of the hospital types considered university hospitals had lower survival rate. Younger patients had a greater loss of expected life span than patients who suffer hip fracture in their more advanced ages.ConclusionsSwedish hip fracture patients who undergo arthroplasty surgery had a high excess hazard of dying in the first half year following surgery, and this excess hazard never subsided to negligible levels at least up to 8 years after surgery. Interestingly having no prior record of illnesses worsened the initial mortality. Men living alone had the highest long-term excess mortality.

show abstract

Section: Discussionmentioning

confidence: 56%

“…Earlier papers have related the long-term mortality among hip fracture patients to the mortality rates in the general population [ 3 , 4 , 6 , 19 ]. These studies highlighted an increased mortality among hip fracture patients compared with the general population using age and sex standardization.…”

Section: Discussionmentioning

confidence: 99%

Relative survival following hemi-and total hip arthroplasty for hip fractures in Sweden

Nemes

Lind

Cnudde

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The relative risk of death was sinking with temporal distance to the trauma, being highest in the first year, which has been also approved in literature [4,11,12]. Studies consistently report age-related drops in the relative mortality risk of both hip and vertebral fractures with residual increased risk for the oldest patients [12,18,23]. This has also been shown for humeral fractures and wrist fractures.…”

Section: Discussionmentioning

confidence: 65%

“…The absolute mortality rose with every age group after vertebral and hip fractures almost proportionally. The literature can confirm this trend [4,12,21,23] and it seems easy to understand that survival rate decreases with age. That is why it is more interesting that upper extremity fractureassociated death rates seemed to stay quite stable among the age groups.…”

Section: Discussionmentioning

confidence: 72%

Fractures’ associated mortality risk in orthogeriatric inpatients: a prospective 2-year survey

et al. 2020

View full text Add to dashboard Cite

Purpose The most common osteoporotic fragility fractures are hip, vertebral and upper extremity fractures. An association with increased mortality is widely described with their occurrence. Fracture-specific associated death rates were determined in a 2-year follow-up for patients treated on an orthogeriatric ward. These were compared amongst each other, examined for changes with age and their impact on the relative mortality risk in relation to the corresponding population. Methods We assessed all patients that were treated in the course of a year on an orthogeriatric ward and suffered from the following injuries: hip (HF), vertebral (VF) and upper extremity fractures (UEF). In a 2-year follow-up it was possible to determine the month of death in the case of the patient’s decease. Pairwise comparisons of the three fracture type death rates were performed through Cox-Regression. We stratified the fracture-dependent absolute mortality and age-specific mortality risk (ASMR) for age groups 71–80, 81–90 and 91–95. Results Overall, we assessed 240 patients with HF, 96 with VF and 127 with UEF over the span of a year. 1- and 2-year-mortality was: HF: 29.6% a.e. 42.9%, VF: 29.2% a.e. 36.5%, UEF: 20.5% a.e 34.6%. Pairwise comparisons of these mortality values revealed no significant differences. In association with HF and VF, we observed a significant increase of 2-year mortality for the oldest compared to the youngest patients (HF: 60.4% vs. 22.5%; p = 0.028) (VF 70% vs. 14.3%; p = 0.033). The analogue comparison for UEF revealed no relevant difference in age-dependent mortality (40.9% vs. 31.1%; p = 0.784). Common for all fracture types ASMR’s were more elevated in the younger patients and decreased with higher age. Conclusion The fracture-related mortality in the 2-year follow-up was comparable. We observed a reduction of relative mortality risk in the oldest patients. While a direct influence of fracture on mortality must be supposed, we support the thesis of the fracture rather being an indicator of higher susceptibility of timely death.

show abstract

“…Short-term and long-term mortality rates of hip fracture patients are common outcome measurements used as quality indicators to evaluate hip fracture care [ 7 , 8 , 9 ]. Reported one-year mortality incidence varies among different nationalities and other individual factors, ranging from 18.56% to 31% [ 10 , 11 , 12 , 13 , 14 , 15 ]. Identifying potentially modifiable prognostic factors associated with increased risk of mortality may help guide physicians, patients, and their families to taking appropriate actions to reduce the risk of mortality for individual patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

et al. 2020

View full text Add to dashboard Cite

Background and Objectives: Although the types of comorbidities and laboratory evaluations are major factors associated with mortality after hip fractures, there have been no studies of the association of these factors and mortality in Thai hip-fracture patients. This study aimed to identify prognostic factors associated with mortality after a hip fracture in the Thai population, including types of comorbidities, treatment-related factors, and laboratory evaluations. Materials and Methods: This five-year retrospective study was conducted in a tertiary care hospital in Thailand. A total of 775 Thai patients who had been admitted with a hip fracture resulting from a simple fall were identified using the International Classification of Disease 10 codes, and a review of their medical charts was conducted. Associations between general factors, comorbidities, laboratory evaluations, treatment factors including type of treatment, and time to death were analyzed using the Cox proportional hazard regression and the hazard ratio (HR). Results: The overall mortality rate of hip fracture patients was 13.94%. Independent prognostic factors found to be significantly associated with mortality were nonoperative treatment (HR = 3.29, p < 0.001), admission glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 (HR = 3.40, p < 0.001), admission hemoglobin concentration <10 g/dL. (HR = 2.31, p < 0.001), chronic obstructive pulmonary disorder (HR = 2.63, p < 0.001), dementia or Alzheimer’s disease (HR = 4.06, p < 0.001), and active malignancy (HR = 6.80, p < 0.001). Conclusion: The types of comorbidities and laboratory evaluation findings associated with mortality in Thai patients with hip fractures include chronic obstructive pulmonary disorder, dementia or Alzheimer’s disease, active malignancy, admission GFR < 30 mL/min/1.73 m2, and admission hemoglobin concentration <10 g/dL. The risks of mortality for Thai hip-fracture patients with these comorbidities or laboratory evaluation findings were 2.5, 4, 7, 3.5, and 2.5 times higher, respectively, than patients without those factors.

show abstract

The impact of hip fracture on mortality in Estonia: a retrospective population-based cohort study

Cited by 15 publications

References 46 publications

Relative survival following hemi-and total hip arthroplasty for hip fractures in Sweden

Relative survival following hemi-and total hip arthroplasty for hip fractures in Sweden

Fractures’ associated mortality risk in orthogeriatric inpatients: a prospective 2-year survey

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

Contact Info

Product

Resources

About