Mortality and its risk factors in nonagenarians after hip fractures

Jin Woo Kim, Dong Hyun Kim, Eui Chan Jang, Young Kyun Lee, Kyunghoi Koo, Yong Chan Ha

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Abstract

Background: The purpose of this study was to assess mortality with a minimum of 2-year follow-up, related risk factors for mortality, and functional outcomes after surgical interventions in nonagenarian patients with hip fractures at the latest follow up. Methods: Between June 2003 and November 2015, 260 nonagenarians (271 hips) with femoral neck and intertrochanteric fractures were included in this retrospective study. Cumulative mortality using the Kaplan-Meier method and risk factors for mortality using Cox proportional-hazards regression model were estimated. As functional outcome, ambulatory ability was assessed before injury and at the latest follow-up. Results: Six-teen patients (16 hips) were lost to follow-up. The mean age at the time of surgery was 92.2 years (range 90–108 years). Mortality rates were 23.4% (57 of 244 patients) at 1 year and 40.6% (99 of 244 patients) at 2 years. Both genders had elevated standardized mortality ratio at 2-year post-fracture compared to that a 1-year post fracture. Multivariate analysis showed that American Society of Anesthesiologists (OR, 1.371; 95% CI, 1.021–1.843; P = 0.036) and time interval from trauma to operation (OR, 1.043; 95% CI, 1.002–1.086; P = 0.039) were significantly associated with risk of mortality. Of 58 patients alive, 13 patients (22.4%) had the same ambulatory ability before and after injury. Conclusions: This study demonstrates that mortality is higher in nonagenarians with hip fracture. Risk factors for mortality in nonagenarians with hip fracture are American Society of Anesthesiologists and time interval from trauma to operation. And, nonagenarians with hip fractures have lower rate of maintaining pre-injury ambulatory ability.

Original languageEnglish
Pages (from-to)850-854
Number of pages5
JournalJournal of Orthopaedic Science
Volume24
Issue number5
DOIs
StatePublished - 1 Sep 2019

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Hip Fractures
Mortality
Wounds and Injuries
Hip
Femoral Neck Fractures
Lost to Follow-Up
Proportional Hazards Models
Multivariate Analysis
Retrospective Studies

Cite this

Kim, Jin Woo ; Kim, Dong Hyun ; Jang, Eui Chan ; Lee, Young Kyun ; Koo, Kyunghoi ; Ha, Yong Chan. / Mortality and its risk factors in nonagenarians after hip fractures. In: Journal of Orthopaedic Science. 2019 ; Vol. 24, No. 5. pp. 850-854.
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abstract = "Background: The purpose of this study was to assess mortality with a minimum of 2-year follow-up, related risk factors for mortality, and functional outcomes after surgical interventions in nonagenarian patients with hip fractures at the latest follow up. Methods: Between June 2003 and November 2015, 260 nonagenarians (271 hips) with femoral neck and intertrochanteric fractures were included in this retrospective study. Cumulative mortality using the Kaplan-Meier method and risk factors for mortality using Cox proportional-hazards regression model were estimated. As functional outcome, ambulatory ability was assessed before injury and at the latest follow-up. Results: Six-teen patients (16 hips) were lost to follow-up. The mean age at the time of surgery was 92.2 years (range 90–108 years). Mortality rates were 23.4{\%} (57 of 244 patients) at 1 year and 40.6{\%} (99 of 244 patients) at 2 years. Both genders had elevated standardized mortality ratio at 2-year post-fracture compared to that a 1-year post fracture. Multivariate analysis showed that American Society of Anesthesiologists (OR, 1.371; 95{\%} CI, 1.021–1.843; P = 0.036) and time interval from trauma to operation (OR, 1.043; 95{\%} CI, 1.002–1.086; P = 0.039) were significantly associated with risk of mortality. Of 58 patients alive, 13 patients (22.4{\%}) had the same ambulatory ability before and after injury. Conclusions: This study demonstrates that mortality is higher in nonagenarians with hip fracture. Risk factors for mortality in nonagenarians with hip fracture are American Society of Anesthesiologists and time interval from trauma to operation. And, nonagenarians with hip fractures have lower rate of maintaining pre-injury ambulatory ability.",
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Mortality and its risk factors in nonagenarians after hip fractures. / Kim, Jin Woo; Kim, Dong Hyun; Jang, Eui Chan; Lee, Young Kyun; Koo, Kyunghoi; Ha, Yong Chan.

In: Journal of Orthopaedic Science, Vol. 24, No. 5, 01.09.2019, p. 850-854.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Mortality and its risk factors in nonagenarians after hip fractures

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AU - Kim, Dong Hyun

AU - Jang, Eui Chan

AU - Lee, Young Kyun

AU - Koo, Kyunghoi

AU - Ha, Yong Chan

PY - 2019/9/1

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N2 - Background: The purpose of this study was to assess mortality with a minimum of 2-year follow-up, related risk factors for mortality, and functional outcomes after surgical interventions in nonagenarian patients with hip fractures at the latest follow up. Methods: Between June 2003 and November 2015, 260 nonagenarians (271 hips) with femoral neck and intertrochanteric fractures were included in this retrospective study. Cumulative mortality using the Kaplan-Meier method and risk factors for mortality using Cox proportional-hazards regression model were estimated. As functional outcome, ambulatory ability was assessed before injury and at the latest follow-up. Results: Six-teen patients (16 hips) were lost to follow-up. The mean age at the time of surgery was 92.2 years (range 90–108 years). Mortality rates were 23.4% (57 of 244 patients) at 1 year and 40.6% (99 of 244 patients) at 2 years. Both genders had elevated standardized mortality ratio at 2-year post-fracture compared to that a 1-year post fracture. Multivariate analysis showed that American Society of Anesthesiologists (OR, 1.371; 95% CI, 1.021–1.843; P = 0.036) and time interval from trauma to operation (OR, 1.043; 95% CI, 1.002–1.086; P = 0.039) were significantly associated with risk of mortality. Of 58 patients alive, 13 patients (22.4%) had the same ambulatory ability before and after injury. Conclusions: This study demonstrates that mortality is higher in nonagenarians with hip fracture. Risk factors for mortality in nonagenarians with hip fracture are American Society of Anesthesiologists and time interval from trauma to operation. And, nonagenarians with hip fractures have lower rate of maintaining pre-injury ambulatory ability.

AB - Background: The purpose of this study was to assess mortality with a minimum of 2-year follow-up, related risk factors for mortality, and functional outcomes after surgical interventions in nonagenarian patients with hip fractures at the latest follow up. Methods: Between June 2003 and November 2015, 260 nonagenarians (271 hips) with femoral neck and intertrochanteric fractures were included in this retrospective study. Cumulative mortality using the Kaplan-Meier method and risk factors for mortality using Cox proportional-hazards regression model were estimated. As functional outcome, ambulatory ability was assessed before injury and at the latest follow-up. Results: Six-teen patients (16 hips) were lost to follow-up. The mean age at the time of surgery was 92.2 years (range 90–108 years). Mortality rates were 23.4% (57 of 244 patients) at 1 year and 40.6% (99 of 244 patients) at 2 years. Both genders had elevated standardized mortality ratio at 2-year post-fracture compared to that a 1-year post fracture. Multivariate analysis showed that American Society of Anesthesiologists (OR, 1.371; 95% CI, 1.021–1.843; P = 0.036) and time interval from trauma to operation (OR, 1.043; 95% CI, 1.002–1.086; P = 0.039) were significantly associated with risk of mortality. Of 58 patients alive, 13 patients (22.4%) had the same ambulatory ability before and after injury. Conclusions: This study demonstrates that mortality is higher in nonagenarians with hip fracture. Risk factors for mortality in nonagenarians with hip fracture are American Society of Anesthesiologists and time interval from trauma to operation. And, nonagenarians with hip fractures have lower rate of maintaining pre-injury ambulatory ability.

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DO - 10.1016/j.jos.2019.02.019

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VL - 24

SP - 850

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JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

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