Akio Shimizu1, Keisuke Maeda2, Ichiro Fujishima3, Jun Kayashita4, Naoharu Mori5, Kiwako Okada6, Chiharu Uno7, Miho Shimizu8, Ryo Momosaki9. 1. Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, 443-8127, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, 480-1195, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, 474-8511, Japan; Institute of Health and Nutrition Nagoya University of Arts and Sciences, Nisshin, 470-0196, Japan. Electronic address: a.shimizu.diet@gmail.com. 2. Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, 480-1195, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, 474-8511, Japan. 3. Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, 443-8127, Japan. 4. Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, 734-8558, Japan. 5. Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, 480-1195, Japan. 6. Institute of Health and Nutrition Nagoya University of Arts and Sciences, Nisshin, 470-0196, Japan. 7. Institute of Health and Nutrition Nagoya University of Arts and Sciences, Nisshin, 470-0196, Japan; Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. 8. Department of Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. 9. Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, 514-8507, Japan.
Abstract
BACKGROUND: Frailty may predict adverse events in patients with hip fractures. This study aimed to investigate the association between frailty and adverse events in patients with hip fractures after surgery using information from Japanese health insurance. METHODS: This retrospective cohort study included patients with hip fractures aged ≥ 65 years using a nationwide database in Japan. We examined the relationship of the frailty risk, which was defined using the Hospital Frailty Risk Score (HFRS), with in-hospital mortality, complications such as delirium and pneumonia, and functional outcomes. We used descriptive analysis, logistic regression, and linear regression analysis to estimate the association between the HFRS and outcomes in patients with hip fracture. RESULTS: We analysed data from 36,192 patients with hip fractures after surgery (mean age: 83.6 ± 6.7 years, female: 79.5%). The proportions of low, intermediate, and high risk of frailty were 68.4%, 28.1%, and 3.5%, respectively. The frailty risk was independently associated with in-hospital mortality (intermediate risk: odds ratio [OR] 1.385, P < 0.001; high risk: OR 1.572; P < 0.001) and the occurrence of complications. Furthermore, each frailty risk was negatively associated with the Barthel Index score at discharge (intermediate risk: coefficient -11.919, P < 0.001; high risk: coefficient -18.044; P < 0.001). CONCLUSIONS: The HFRS could predict adverse events, including in-hospital mortality, in Japanese older patients with hip fractures. This finding supports the validity of using the HFRS in clinical practice for patients with hip fractures.
BACKGROUND: Frailty may predict adverse events in patients with hip fractures. This study aimed to investigate the association between frailty and adverse events in patients with hip fractures after surgery using information from Japanese health insurance. METHODS: This retrospective cohort study included patients with hip fractures aged ≥ 65 years using a nationwide database in Japan. We examined the relationship of the frailty risk, which was defined using the Hospital Frailty Risk Score (HFRS), with in-hospital mortality, complications such as delirium and pneumonia, and functional outcomes. We used descriptive analysis, logistic regression, and linear regression analysis to estimate the association between the HFRS and outcomes in patients with hip fracture. RESULTS: We analysed data from 36,192 patients with hip fractures after surgery (mean age: 83.6 ± 6.7 years, female: 79.5%). The proportions of low, intermediate, and high risk of frailty were 68.4%, 28.1%, and 3.5%, respectively. The frailty risk was independently associated with in-hospital mortality (intermediate risk: odds ratio [OR] 1.385, P < 0.001; high risk: OR 1.572; P < 0.001) and the occurrence of complications. Furthermore, each frailty risk was negatively associated with the Barthel Index score at discharge (intermediate risk: coefficient -11.919, P < 0.001; high risk: coefficient -18.044; P < 0.001). CONCLUSIONS: The HFRS could predict adverse events, including in-hospital mortality, in Japanese older patients with hip fractures. This finding supports the validity of using the HFRS in clinical practice for patients with hip fractures.
Authors: Maximilian Peter Forssten; Yang Cao; Dhanisha Jayesh Trivedi; Lovisa Ekestubbe; Tomas Borg; Gary Alan Bass; Ahmad Mohammad Ismail; Shahin Mohseni Journal: Trauma Surg Acute Care Open Date: 2022-09-13