Does previous fragility fracture impact upon mortality in a hip fracture cohort? a retrospective study.
Blue Book Guidelines
Fragility fracture
Hip fracture
Mortality in hip fracture patients
Osteoporosis
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
03
10
2022
accepted:
29
12
2022
medline:
23
10
2023
pubmed:
31
1
2023
entrez:
30
1
2023
Statut:
ppublish
Résumé
Fragility fractures are described as fractures resulting from low-energy trauma and are considered diagnostic of reduced bone mineral density or osteoporosis. They often present as hip fractures with hip fractures remaining a common but devastating injury among older patients. Many factors influence a patient's risk of hip fracture and their subsequent risk of death. In this study, we examined if previous fragility fracture impacts upon mortality after hip fracture. This was a retrospective single-center cohort study of patients included in the Irish Hip Fracture registry over a 5-year time period. Epidemiological data including gender, age, type of fracture, type of surgery, bone protection medication, American Society of Anesthetics (ASA) grade, and post-fracture outcomes including death at 30 days and death at 1 year were recorded. The presence or absence of a previous fragility fracture was examined to explore if a previous fragility fracture was an independent predictor of mortality. There were 964 patients included, and 290 of whom had sustained a previous fragility fracture; 289 patients were males and 675 females, 33 patients had died in the 30 days following their surgery, and 180 patients had died within 1 year. We found statistically significant results for gender and age but not for previous fragility fracture influencing mortality (p value 0.230). We found that previous fragility fracture does not impact upon mortality in a hip fracture cohort. However, gender and age did impact upon mortality in this study.
Sections du résumé
BACKGROUND
BACKGROUND
Fragility fractures are described as fractures resulting from low-energy trauma and are considered diagnostic of reduced bone mineral density or osteoporosis. They often present as hip fractures with hip fractures remaining a common but devastating injury among older patients. Many factors influence a patient's risk of hip fracture and their subsequent risk of death.
AIM
OBJECTIVE
In this study, we examined if previous fragility fracture impacts upon mortality after hip fracture.
METHODS
METHODS
This was a retrospective single-center cohort study of patients included in the Irish Hip Fracture registry over a 5-year time period. Epidemiological data including gender, age, type of fracture, type of surgery, bone protection medication, American Society of Anesthetics (ASA) grade, and post-fracture outcomes including death at 30 days and death at 1 year were recorded. The presence or absence of a previous fragility fracture was examined to explore if a previous fragility fracture was an independent predictor of mortality.
RESULTS
RESULTS
There were 964 patients included, and 290 of whom had sustained a previous fragility fracture; 289 patients were males and 675 females, 33 patients had died in the 30 days following their surgery, and 180 patients had died within 1 year. We found statistically significant results for gender and age but not for previous fragility fracture influencing mortality (p value 0.230).
CONCLUSION
CONCLUSIONS
We found that previous fragility fracture does not impact upon mortality in a hip fracture cohort. However, gender and age did impact upon mortality in this study.
Identifiants
pubmed: 36715792
doi: 10.1007/s11845-022-03267-5
pii: 10.1007/s11845-022-03267-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2243-2249Informations de copyright
© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Références
Lisk R, Yeong K (2014) Reducing mortality from hip fractures: a systematic quality improvement programme. BMJ Open Qual 3(1):u205006.w2103
Care of patients with fragility fracture (Blue Book) [Internet]. British Geriatrics Society. [cited 2021 Aug 16]. Available from: https://www.bgs.org.uk/resources/care-of-patients-with-fragility-fracture-blue-book
Irish Hip Fracture Database National Report (2019) NOCA [Internet]. [cited 2021 Aug 12]. Available from: https://www.noca.ie/index.php/documents/ihfd-national-report-2019
Hirsch JA, Beall DP, Chambers MR et al (2018) Management of vertebral fragility fractures: a clinical care pathway developed by a multispecialty panel using the RAND/UCLA appropriateness method. Spine J 18(11):2152–2161
doi: 10.1016/j.spinee.2018.07.025
pubmed: 30096377
Katsoulis M, Benetou V, Karapetyan T et al (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med 281:300–310
doi: 10.1111/joim.12586
pubmed: 28093824
Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739
doi: 10.1359/jbmr.2000.15.4.721
pubmed: 10780864
Mitchell RM, Jewell P, Javaid MK et al (2017) Reporting of vertebral fragility fractures: can radiologists help reduce the number of hip fractures? Arch Osteoporos 12(1)
Mo J, Huang K, Wang X et al (2018) The sensitivity of orthopaedic surgeons to the secondary prevention of fragility fractures. J Bone Joint Surg Am 100:e153
doi: 10.2106/JBJS.17.01297
pubmed: 30562300
Death Events [Internet]. [cited 2022 Aug 9]. Available from: https://deathevents.gov.ie/
McCarthy CJ, Kelly MA, Kenny PJ (2021) Assessment of previous fracture and anti-osteoporotic medication prescription in hip fracture patients. Ir J Med Sci
Gehlbach S, Saag KG, Adachi JD et al (2012) Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women. J Bone Miner Res 27(3):-. https://doi.org/10.1002/jbmr.1476
Aguado-Maestro I, Panteli M, García-Alonso M et al (2017) Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures. Injury 48:S27–33
doi: 10.1016/j.injury.2017.08.035
pubmed: 28851521
Downey C, Kelly M, Quinlan JF (2019) Changing trends in the mortality rate at 1-year post hip fracture - a systematic review. World J Orthop 10(3):166–175
doi: 10.5312/wjo.v10.i3.166
pubmed: 30918799
pmcid: 6428998
Sullivan KJ, Husak LE, Altebarmakian M et al (2016) Demographic factors in hip fracture incidence and mortality rates in California, 2000–2011. J Orthop Surg Res 8(11):4
doi: 10.1186/s13018-015-0332-3
Weltgesundheitsorganisation, editor (2003) Prevention and management of osteoporosis: report of a WHO scientific group; [WHO Scientific Group Meeting on Prevention and Management of Osteoporosis, Geneva, 7 - 10 April]. Geneva: World Health Organization. 192 p. (WHO Technical Report Series)
Holt G, Smith R, Duncan K et al (2008) Gender differences in epidemiology and outcome after hip fracture: evidence from the Scottish Hip Fracture Audit. J Bone Joint Surg Br 90(4):480–483
doi: 10.1302/0301-620X.90B4.20264
pubmed: 18378923