Patrocinio Ariza-Vega1, Morten Tange Kristensen2, Lydia Martín-Martín3, Jose Juan Jiménez-Moleón4. 1. Department of Rehabilitation, Rehabilitation and Traumatology Virgen de las Nieves University Hospital, Granada, Spain; Department of Physical Therapy, University of Granada, Granada, Spain. Electronic address: pariza@ugr.es. 2. Physical Medicine and Rehabilitation Research-Copenhagen, Department of Physical Therapy and Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark. 3. Department of Physical Therapy, University of Granada, Granada, Spain. 4. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Ciber of Epidemiology and Public Health, Granada, Spain.
Abstract
OBJECTIVES: To determine 1-year mortality and predisposing factors in older people who had surgery after a hip fracture. DESIGN: Prospective cohort study. SETTING: Public acute hospital, trauma service. PARTICIPANTS: Patients (N=281) aged ≥65 years who were admitted to the hospital with a hip fracture from January 2009 to January 2010, and followed up for 1 year thereafter. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Cumulative survival probability up to 1 year from surgery was calculated by means of Kaplan-Meier charts, and Cox regression models were performed to analyze the factors associated with mortality. Data were collected from medical charts and by interviews. Health status was evaluated using the American Society of Anesthesiologists rating, prefracture functional level with the FIM, and cognitive status with the Pfeiffer score. RESULTS: The 1-year mortality for the 281 patients who were followed up was 21% (95% confidence interval [CI], 16.1%-25.9%). A non-weight-bearing status was associated with increased mortality in unadjusted analyses (hazard ratio [HR]=1.99; 95% CI, 1.16-3.43), but 5 other factors were identified when entered into the multiple Cox regression model: age (HR=1.05; 95% CI, 1-1.09), male sex (HR=2.92; 95% CI, 1.58-5.39), low health status (HR=2.8; 95% CI, 1.29-6.09), low prefracture function (HR=.98; 95% CI, .97-.99), and change of residence (HR=3.21; 95% CI, 1.43-7.17). CONCLUSIONS: The overall 1-year mortality rate was 21%. Change of residence is the only potentially modifiable risk factor, independent of the following other traditional risk factors that were found: age, sex, health status, and prefracture functional level. Furthermore, 2 to 4 weeks of non-weight-bearing status, which is considered modifiable, is also associated with increased mortality rates in unadjusted analyses.
OBJECTIVES: To determine 1-year mortality and predisposing factors in older people who had surgery after a hip fracture. DESIGN: Prospective cohort study. SETTING: Public acute hospital, trauma service. PARTICIPANTS: Patients (N=281) aged ≥65 years who were admitted to the hospital with a hip fracture from January 2009 to January 2010, and followed up for 1 year thereafter. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Cumulative survival probability up to 1 year from surgery was calculated by means of Kaplan-Meier charts, and Cox regression models were performed to analyze the factors associated with mortality. Data were collected from medical charts and by interviews. Health status was evaluated using the American Society of Anesthesiologists rating, prefracture functional level with the FIM, and cognitive status with the Pfeiffer score. RESULTS: The 1-year mortality for the 281 patients who were followed up was 21% (95% confidence interval [CI], 16.1%-25.9%). A non-weight-bearing status was associated with increased mortality in unadjusted analyses (hazard ratio [HR]=1.99; 95% CI, 1.16-3.43), but 5 other factors were identified when entered into the multiple Cox regression model: age (HR=1.05; 95% CI, 1-1.09), male sex (HR=2.92; 95% CI, 1.58-5.39), low health status (HR=2.8; 95% CI, 1.29-6.09), low prefracture function (HR=.98; 95% CI, .97-.99), and change of residence (HR=3.21; 95% CI, 1.43-7.17). CONCLUSIONS: The overall 1-year mortality rate was 21%. Change of residence is the only potentially modifiable risk factor, independent of the following other traditional risk factors that were found: age, sex, health status, and prefracture functional level. Furthermore, 2 to 4 weeks of non-weight-bearing status, which is considered modifiable, is also associated with increased mortality rates in unadjusted analyses.
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Authors: Denise L Orwig; Danielle S Abraham; Marc C Hochberg; Ann Gruber-Baldini; Jack M Guralnik; Anne R Cappola; Justine Golden; Gregory E Hicks; Ram R Miller; Barbara Resnick; Michelle Shardell; Robert S Sterling; Rashmita Bajracharya; Jay Magaziner Journal: J Gerontol A Biol Sci Med Sci Date: 2022-07-05 Impact factor: 6.591
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