High short-term and long-term excess mortality in geriatric patients after hip fracture: a prospective cohort study in Taiwan.
BMC Musculoskelet Disord
; 15: 151, 2014 May 09.
Article
em En
| MEDLINE
| ID: mdl-24886144
ABSTRACT
BACKGROUND:
Hip fracture has a high mortality rate, but the actual level of long-term excess mortality and its impact on population-wide mortality remains controversial. The present prospective study investigated short- and long-term excess mortality after hip fractures with adjustment of other risk factors. We calculated the population attributable risk proportion (PARP) to assess the impact of each risk factor on excess mortality.METHODS:
We recruited 217 elders with hip fractures and 215 age- and sex-matched patients without fractures from the geriatric department of the same hospital. The mean follow-up time was 46.1 months (range 35 to 57 months). We recorded data on 55 covariates, including baseline details about health, function, and bone mineral density. We used the multivariate Cox proportional hazards model to analyze hazard ratios (HRs) of short-term (<12 months follow-up) and long-term (⧠2 months follow-up) excess mortality for each covariate and calculated their PARP.RESULTS:
Patients with hip fractures had a higher short-term mortality than non-fractured patients, and the long-term excess mortality associated with hip fracture remained high. The significant risk factors for short-term mortality were hip fracture, comorbidities, and lower (below cutoff) Mini Mental State Examination score with HRs of 2.4, 2.3, and 2.3, respectively. Their PARPs were 44.7%, 38.1%, and 34.3%, respectively. The significant risk factors for long-term mortality were hip fracture (HR 2.7; PARP 48.0%), lower T-score (HR 3.3; PARP 36.2%), lower body mass index (HR 2.5; PARP 42.8%), comorbidities (HR 2.1; PARP 34.8%), difficulty in activities of daily living (HR 1.9; PARP 31.8%), and smoking (HR 2.5; PARP 19.2%).CONCLUSIONS:
After comprehensive adjustment, hip fracture was a significant risk factor and contributed the most to long-term as well as short-term excess mortality. Its adequate prevention and treatment should be targeted.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Avaliação Geriátrica
/
Fraturas do Quadril
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
BMC Musculoskelet Disord
Assunto da revista:
FISIOLOGIA
/
ORTOPEDIA
Ano de publicação:
2014
Tipo de documento:
Article