Year to year comparison of 2000–2015 in hip fracture management: same survival rate despite older and more fragile patients

Trévisan, C.; Gallinari, Gianluca; Klumpp, Raymond; Menon, Alessandra; Compagnoni, Roberto

doi:10.1007/s40520-018-1047-1

Cited by 18 publications

(18 citation statements)

References 27 publications

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“…Our results are consistent with previous findings of considerable improvements in survival rates among patients with cardiovascular diseases [15,17,35] and stable survival rates among hip fracture patients [36,37]. The rapid increases in remaining life expectancy found among subpopulations with a history of colon or breast cancer, and the smaller improvements found among those with a history of lung cancer, also correspond to previously observed trends in cancer survival [16,23].…”

Section: Discussionsupporting

confidence: 92%

“…The lack of increases in life expectancy in the hip fracture population is striking. A recent study has attributed the stagnation in the length of survival after hip fracture to a higher prevalence of comorbidities [37]. In line with this observation, we found some increases in the remaining life expectancy among individuals with a history of hip fracture when stratifying by comorbidity level, which indicates that comorbidity has confounded survival trends in the hip fracture population.…”

Section: Discussionsupporting

confidence: 88%

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Trends in life expectancy: did the gap between the healthy and the ill widen or close?

Meyer

Drefahl

Ahlbom

et al. 2020

BMC Med

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Background: During the past decades, life expectancy has continued to increase in most high-income countries. Previous research suggests that improvements in life expectancy have primarily been driven by advances at the upper end of the health distribution, while parts of the population have lagged behind. Using data from the entire Swedish population, this study aims to examine the life expectancy development among subgroups of individuals with a history of common diseases relative to that of the general population. Methods: The remaining life expectancy at age 65 was estimated for each year in 1998-2017 among individuals with a history of disease, and for the total Swedish population. We defined population subgroups as individuals with a history of myocardial infarction, ischemic or hemorrhagic stroke, hip fracture, or colon, breast, or lung cancer. We further distinguished between different educational levels and Charlson comorbidity index scores. Results: Life expectancy gains have been larger for men and women with a history of myocardial infarction, ischemic or hemorrhagic stroke, and colon or breast cancer than for the general population. The life expectancy gap between individuals with a history of hip fracture or lung cancer and the general population has, however, been growing. Education and comorbidity have affected mortality levels, but have not altered the rate of increase in life expectancy among individuals with disease history. The female advantage in life expectancy was less pronounced among individuals with disease history than among the general population. Conclusions: Life expectancy has increased faster in many subpopulations with a history of disease than in the general population, while still remaining at lower levels. Improvements in life expectancy have been observed regardless of comorbidity or educational level. These findings suggest that the rise in overall life expectancy reflects more than just improved survival among the healthy or the delayed onset of disease.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Trends in life expectancy: did the gap between the healthy and the ill widen or close?

Meyer

Drefahl

Ahlbom

et al. 2020

BMC Med

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“…Cohort 2018 presented a significantly higher morbidity in terms of mean comorbiditycount, multimorbidity and preoperative ASA-class. A few previous studies have also compared the population over time and results of a general increase in comorbidity-burden coincide with ours (22,(24)(25)(26)(27). Multimorbidity increased from 13 to 28% (95%CI -27;-2), comparable with the increase of 33.9 to 43.3% found in a large observational study between 2000 and 2016 in USA by Bekeris et al, using the same definition of multi-and comorbidity (25).…”

Section: Comorbidity and Drug Usesupporting

confidence: 83%

“…Some comorbidities of the Elixhauser comorbidity measure were not prevalent at all in our results, possibly also attributable to small samplesize. Trevisan et al preformed similarly to us a smaller study comparing a cohort from 2000 with a cohort from 2015 in Italy and also found significant increases in renal disease in addition to alzheimers, COPD, and valvulopathy (26). Significant increases in renal disease, cardiovascular disease and diabetes have also been reported in the larger longitudinal studies by Jantzen et al from 1999Jantzen et al from -2012 Evidently there seems to have been a shift towards increased comorbidity over time.…”

Section: Comorbidity and Drug Usementioning

confidence: 67%

“…Contradictory to earlier estimates, hip fracture incidence is declining and Swedish data suggests that coherent survival rates have remained unaltered (21), possibly explained by a potential change in morbidity of the population. A few previous studies have examined the development of the population and its morbidity over time and present homogenous results of an increased comorbidity-burden and polypharmacy while mortality has decreased or remained unchanged, possibly portraying advances in treatment of comorbidities, hip fracture and individualized care (22)(23)(24)(25)(26)(27). In light of this there is a value in studying how a possible increase in morbidity may reflect possible changes in malnutrition and sarcopenia as well as specific drug use, to our knowledge not yet studied.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Patients with Hip Fracture, Ten Years Apart: Morbidity, Malnutrition and Sarcopenia

Probert

Lööw

Akner

et al. 2020

The Journal of nutrition, health and aging

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Objectives To investigate possible differences in morbidity, malnutrition, sarcopenia and specific drug use in patients with hip fracture, ten years apart. To analyse 1-year mortality and possible associations with variables. Design A prospective, observational study. Setting Örebro University Hospital, Sweden. Participants Two cohorts of patients with hip fracture, included in 2008 (n=78) and 2018 (n=76). Measurements Presence of comorbidity according to the Elixhauser comorbidity measure, multimorbidity defined as ≥3 comorbidities, preoperative American Society of Anaesthesiologists Classification (ASA-class), malnutrition according to the definition by the Global Leadership Initiative on Malnutrition (GLIM), sarcopenia according to the most recently revised definition by the European Working Group on Sarcopenia in Older People (EWGSOP), polypharmacy defined as ≥5 prescribed medications, use of Potentially Inappropriate Medications (PIM) and Fall-Risk-Increasing-Drugs (FRID) and postoperative 1-year mortality. Results When comparing the cohorts, significant increases over time was seen for mean comorbidity-count (Difference −1; p=0.002), multimorbidity (Difference −15%; 95%CI −27;−2), ASA-class 3–4 (Difference −25%; 95%CI −39;−9) and polypharmacy (Difference −17%; 95%CI −32;−2). Prevalence of malnutrition and sarcopenia coherently decreased with 22% (95%CI 5;37) and 14% (95%CI 1;29) respectively. One-year mortality remained unchanged and a significant association was found for a higher ASA-class in 2008 (OR 3.5, 95%CI 1.1;11.6) when adjusted for age. Results on PIM exposure suggest a decrease while exposure to FRID remained high. Conclusion Our findings support an increasing morbidity within the population over time. However, also presented is a coherent decrease in malnutrition and sarcopenia, suggesting a decrease in frailty as a possible explanation for the observed unaltered mortality, in turn suggesting advances in treatment of comorbidities.

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Employing Nano-Extracellular Vesicles (NEVs) as a Potent Therapy in Ameliorating Bone Loss in Osteoporosis

Sharma,

Bhardwaj,

Srivastava

2024

Nanotechnology in the Life Sciences

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Year to year comparison of 2000–2015 in hip fracture management: same survival rate despite older and more fragile patients

Cited by 18 publications

References 27 publications

Trends in life expectancy: did the gap between the healthy and the ill widen or close?

Trends in life expectancy: did the gap between the healthy and the ill widen or close?

A Comparison of Patients with Hip Fracture, Ten Years Apart: Morbidity, Malnutrition and Sarcopenia

Employing Nano-Extracellular Vesicles (NEVs) as a Potent Therapy in Ameliorating Bone Loss in Osteoporosis

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