ID | 116197 |
著者 |
Kimura, Atsushi
Kyushu University
Matsumoto, Yoshihiro
Kyushu University
若田, 好史
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
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キーワード | activities of daily living
Barthel index
body mass index
frail elderly
hip fractures
mortality rate
osteoporosis
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資料タイプ |
学術雑誌論文
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抄録 | 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.
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掲載誌名 |
Journal of Orthopaedic Surgery
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ISSN | 23094990
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出版者 | Sage|Asia Pacific Orthopaedic Association
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巻 | 27
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号 | 3
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開始ページ | 1
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終了ページ | 8
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発行日 | 2019-08-29
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権利情報 | 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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言語 |
eng
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著者版フラグ |
出版社版
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部局 |
病院
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