R M Y Wong1, R W K Ng2, W W Chau3, W H Liu2, S K H Chow3, C Y Tso2, N Tang2, W-H Cheung3. 1. Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China. ronald.wong@cuhk.edu.hk. 2. Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China. 3. Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Abstract
Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates. INTRODUCTION: Hip fractures rank amongst the top 10 causes of disability and current mortality of hip fractures is high. Objectives were to determine 1) prevalence of cognitive impairment, 2) whether Montreal Cognitive Assessment (MoCA) score was an independent risk factor associated with mortality, 3) MoCA cut-off that result in high risk of mortality. METHODS: This was a cohort study between July 2019 to June 2020. Inclusion criteria were 1) hip fracture, 2) > = 65 years old, and 3) low-energy trauma. Patients undergo assessment for cognitive impairment with MoCA. Prevalence was assessed, MoCA cut-off point, and accuracy of statistical model was evaluated. Logistic regression modelling was used to assess association between mortality and MoCA. RESULTS: There were 260 patients recruited. Two hundred twenty-five patients had MoCA score < 22 signifying cognitive impairment, and 202 patients had MoCA score of < 19. 46 hip fracture patients died at 1-year follow-up. 45 of these patients had MoCA score < 19, and 1 patient had a MoCA > 22. Results showed statistical significance and good model effect (at least 0.8) with MoCA cut-off points between < 15 and < 19 (p < 0.05). After controlling confounding factors, statistical significance still existed in MoCA cut-off point at < 15 (odds ratio (95% CI) = 11.71 (1.14, 120.71); p = 0.04). CONCLUSION: Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality in hip fracture patients. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality at 1-year after a hip fracture. AUC with MoCA score < 15 was 0.948. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates.
Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates. INTRODUCTION: Hip fractures rank amongst the top 10 causes of disability and current mortality of hip fractures is high. Objectives were to determine 1) prevalence of cognitive impairment, 2) whether Montreal Cognitive Assessment (MoCA) score was an independent risk factor associated with mortality, 3) MoCA cut-off that result in high risk of mortality. METHODS: This was a cohort study between July 2019 to June 2020. Inclusion criteria were 1) hip fracture, 2) > = 65 years old, and 3) low-energy trauma. Patients undergo assessment for cognitive impairment with MoCA. Prevalence was assessed, MoCA cut-off point, and accuracy of statistical model was evaluated. Logistic regression modelling was used to assess association between mortality and MoCA. RESULTS: There were 260 patients recruited. Two hundred twenty-five patients had MoCA score < 22 signifying cognitive impairment, and 202 patients had MoCA score of < 19. 46 hip fracture patients died at 1-year follow-up. 45 of these patients had MoCA score < 19, and 1 patient had a MoCA > 22. Results showed statistical significance and good model effect (at least 0.8) with MoCA cut-off points between < 15 and < 19 (p < 0.05). After controlling confounding factors, statistical significance still existed in MoCA cut-off point at < 15 (odds ratio (95% CI) = 11.71 (1.14, 120.71); p = 0.04). CONCLUSION: Prevalence of cognitive impairment in hip fractures was 86.5%. MoCA is an independent risk factor of mortality in hip fracture patients. MoCA score of < 15 is correlated with 11.71 times increased risk of mortality at 1-year after a hip fracture. AUC with MoCA score < 15 was 0.948. Early attention and caution should be given to these patients for appropriate intervention to decrease mortality rates.
Authors: Jorma Panula; Harri Pihlajamäki; Ville M Mattila; Pekka Jaatinen; Tero Vahlberg; Pertti Aarnio; Sirkka-Liisa Kivelä Journal: BMC Musculoskelet Disord Date: 2011-05-20 Impact factor: 2.362
Authors: Ronald Man Yeung Wong; Yao Zu; Wai Wang Chau; Chi Yin Tso; Wing Hong Liu; Raymond Wai Kit Ng; Simon Kwoon Ho Chow; Wing Hoi Cheung; Ning Tang; Kevin Ki Wai Ho Journal: Sci Rep Date: 2022-03-19 Impact factor: 4.379
Authors: Ronald Man Yeung Wong; Wing-Hoi Cheung; Simon Kwoon Ho Chow; Raymond Wai Kit Ng; Wilson Li; Albert Yung-Chak Hsu; Kam Kwong Wong; Angela Wing-Hang Ho; Shing-Hing Choi; Christian Xinshuo Fang; Chun Fung Chan; Ka-Hei Leung; Kwok-Keung Chu; Timothy Chi Yui Kwok; Ming Hui Yang; Maoyi Tian; Sheung Wai Law Journal: J Orthop Translat Date: 2022-10-10 Impact factor: 4.889