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ID 116197
Author
Kimura, Atsushi Kyushu University
Matsumoto, Yoshihiro Kyushu University
Wakata, Yoshifumi Tokushima University
Oyamada, Akiko Saga Handicapped Children’s Hospital
Ohishi, Masanobu Chihaya Hospital
Fujiwara, Toshifumi Kyushu University
Ikuta, Ko Karatsu Red Cross Hospital
Tsuchiya, Kuniyoshi JCHO Kyushu Hospital
Tayama, Naohisa Steel Memorial Yawata Hospital
Tomari, Shinji Fukuoka Red Cross Hospital
Miyahara, Hisaaki National Kyushu Medical Center
Mae, Takao Saga-ken Medical Center Koseikan
Hara, Toshihiko Aso Iizuka Hospital
Saito, Taichi Fukuoka City Hospital
Arizono, Takeshi Kyushu Central Hospital
Kaji, Kozo Kyushu Rosai Hospital
Mawatari, Taro Hamanomachi Hospital
Fujiwara, Masami Sada Hospital
Sakimura, Riku Harasanshin Hospital
Shin, Kunichika Saiseikai Yahata General Hospital
Ninomiya, Kenichi Koga Hospital 21
Nakaie, Kazutoshi Fukuoka-Higashi Medical Center
Antoku, Yasuaki Oita University
Tokunaga, Shoji Clinical Research Support Center Kyushu
Nakashima, Naoki Kyushu University
Iwamoto, Yukihide Kyushu Rosai Hospital
Nakashima, Yasuharu Kyushu University
Keywords
activities of daily living
Barthel index
body mass index
frail elderly
hip fractures
mortality rate
osteoporosis
Content Type
Journal Article
Description
Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8–12.0%, n = 45). Log-rank test revealed that previous fractures (p = 0.003), Barthel index (BI) at discharge (p = 0.011), and place-to-discharge (p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking (p = 0.007), length of hospital stay (LOS; p = 0.009), and BI (p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m2 (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females. Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m2, TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.
Journal Title
Journal of Orthopaedic Surgery
ISSN
23094990
Publisher
Sage|Asia Pacific Orthopaedic Association
Volume
27
Issue
3
Start Page
1
End Page
8
Published Date
2019-08-29
Rights
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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language
eng
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departments
University Hospital