Carlo Trevisan1,2, Gianluca Gallinari1, Raymond Klumpp2, Alessandra Menon3,4, Riccardo Compagnoni5,6. 1. Università degli Studi di Milano Bicocca, Via Grigna 11, 20900, Monza, Italy. 2. ASST Bergamo Est, Ospedale Bolognini, Via Paderno 21, 24068, Seriate, Italy. 3. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. 4. 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy. 5. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. riccardo.compagnoni@gmail.com. 6. 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy. riccardo.compagnoni@gmail.com.
Abstract
PURPOSE: The aim of this study was to compare clinical data, comorbidities and survival rates at 30 days and 1 year in two groups with femoral fractures, the first including patients admitted in 2000, and the other including patients admitted in 2015. The hypothesis of the study is that patients admitted in 2015 have more comorbidities and will therefore have a lower survival rate at 30 days and 1 year from trauma. METHODS: Patients admitted to the hospital with proximal femoral fractures in 2000 (90 patients) and 2015 (167 patients) were retrospectively reviewed. The following data were collected: age, gender, source of admission, ASA score, comorbidities, time from admission to surgery and length of hospital stay. The Charlson Comorbidity Index (CCI) score, a measure of comorbidity, and the Nottingham Hip Fracture Score (NHFS), a predictor of 30-day and 1-year mortality after hip fracture, were both calculated. RESULTS: Patients in the 2015 group were older and more institutionalized before fracture (p < 0.05), with a significant increase in Alzheimer's disease, chronic obstructive pulmonary disease, congestive heart failure and renal impairment. The length of stay was significantly lower in 2015. The NHFS and CCI were significantly higher in 2000. Mortality at 30 days and 1 year did not differ significantly in 2000 when compared to 2015. The CCI had the best predictive ability for mortality in both groups at 30 days and 1 year. CONCLUSIONS: The increase of comorbidities was not found to be correlated to increased mortality. This could be explained by enhanced patient management permitting earlier mobilization and weight bearing.
PURPOSE: The aim of this study was to compare clinical data, comorbidities and survival rates at 30 days and 1 year in two groups with femoral fractures, the first including patients admitted in 2000, and the other including patients admitted in 2015. The hypothesis of the study is that patients admitted in 2015 have more comorbidities and will therefore have a lower survival rate at 30 days and 1 year from trauma. METHODS:Patients admitted to the hospital with proximal femoral fractures in 2000 (90 patients) and 2015 (167 patients) were retrospectively reviewed. The following data were collected: age, gender, source of admission, ASA score, comorbidities, time from admission to surgery and length of hospital stay. The Charlson Comorbidity Index (CCI) score, a measure of comorbidity, and the Nottingham Hip Fracture Score (NHFS), a predictor of 30-day and 1-year mortality after hip fracture, were both calculated. RESULTS:Patients in the 2015 group were older and more institutionalized before fracture (p < 0.05), with a significant increase in Alzheimer's disease, chronic obstructive pulmonary disease, congestive heart failure and renal impairment. The length of stay was significantly lower in 2015. The NHFS and CCI were significantly higher in 2000. Mortality at 30 days and 1 year did not differ significantly in 2000 when compared to 2015. The CCI had the best predictive ability for mortality in both groups at 30 days and 1 year. CONCLUSIONS: The increase of comorbidities was not found to be correlated to increased mortality. This could be explained by enhanced patient management permitting earlier mobilization and weight bearing.
Authors: Anna C Meyer; Stina Ek; Sven Drefahl; Anders Ahlbom; Margareta Hedström; Karin Modig Journal: Epidemiology Date: 2021-05-01 Impact factor: 4.860