Objective: this systematic review aimed to identify immutable and modifiable prognostic factors of functional outcomes and their proposed mechanism after hip fracture surgery.
Design: systematic search of MEDLINE, Embase, CINAHL, PEDRO, OpenGrey and ClinicalTrials.gov for observational studies of prognostic factors of functional outcome after hip fracture among surgically treated adults with mean age of 65 years and older. Study selection, quality assessment, and data extraction were completed independently by two reviewers. The Quality in Prognosis Studies Tool was used for quality assessment and assigning a level of evidence to factors. Proposed mechanisms for reported associations were extracted from discussion sections.
Results: from 33 studies of 9,552 patients, we identified 25 prognostic factors of functional outcome after hip fracture surgery. We organised factors into groups: demographics, injury and comorbidities, body composition, complications, and acute care. We assigned two factors a weak evidence level-anaemia and cognition. We assigned Parkinson's disease an inconclusive evidence level. We could not assign an evidence level to the remaining 22 factors due to the high risk of bias across studies. Frailty was the proposed mechanism for the association between anaemia and functional outcome. Medication management, perceived potential, complications and time to mobility were proposed as mechanisms for the association between cognition and functional outcome.
Conclusion: we identified one modifiable and one immutable prognostic factor for functional outcomes after hip fracture surgery. Future research may target patients with anaemia or cognitive impairment by intervening on the prognostic factor or the underlying mechanisms.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ageing/afy057 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adverse Outcomes After Cemented and Cementless Primary Elective Total Hip Arthroplasty in 60,064 Matched Patients: A Study of Data From the Swedish Arthroplasty Register.
J Arthroplasty
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
Introduction: The choice between cemented and cementless fixation in primary elective total hip arthroplasty (THA) remains a subject of ongoing debate. However, comparisons between the two are subject to limited adjustments for patient characteristics, diagnoses, and surgical factors, as well as by limited outcome time endpoints. Our study aimed to compare the effect of femoral fixation on safety and implant survival outcomes in matched patients.
View Article and Find Full Text PDFBallistic femoral neck fractures: Associated injuries and outcomes.
Injury
January 2025
Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States. Electronic address:
Background: Ballistic fractures of the femoral neck, rare injuries that overwhelmingly affect younger adults, pose significant challenges to the treating surgeon. However, there is limited literature that the treating surgeon can leverage to guide their treatment decisions. The goal of this study is to describe the demographics, associated injuries, outcomes, and complications associated with ballistic femoral neck fractures.
View Article and Find Full Text PDFFracture Prevention with Infrequent Zoledronate in Women 50 to 60 Years of Age.
N Engl J Med
January 2025
From the Department of Medicine, University of Auckland, Auckland, New Zealand (M.J.B., Z.N., A.M., C.G., V.P., B.M., A.G., I.R.R., G.G., A.H.); the Department of Psychology, Stanford University, Stanford, CA (C.G.); and the Department of Radiology, Starship Hospital, Auckland, New Zealand (S.B.).
Background: Zoledronate prevents fractures in older women when administered every 12 to 18 months, but its effects on bone density and bone turnover persist beyond 5 years. Whether infrequent zoledronate administration would prevent vertebral fractures in early postmenopausal women is unknown.
Methods: We conducted a 10-year, prospective, double-blind, randomized, placebo-controlled trial involving early postmenopausal women (50 to 60 years of age) with bone mineral density T scores lower than 0 and higher than -2.
Thoracolumbar Fracture: A Natural History Study of Survival Following Injury.
J Bone Joint Surg Am
November 2024
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Background: Fractures of the thoracic and lumbar spine are increasingly common. Although it is known that such fractures may elevate the risk of near-term morbidity, the natural history of patients who sustain such injuries remains poorly described. We sought to characterize the natural history of patients treated for thoracolumbar fractures and to understand clinical and sociodemographic factors associated with survival.
View Article and Find Full Text PDFAdvanced Care Planning for the Orthopaedic Patient.
J Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
➢ Advanced care planning most commonly refers to the act of planning and preparing for decisions with regard to end-of-life care and/or serious illness based on a patient's personal values, life goals, and preferences.➢ Over time, advanced care planning and its formalization through advanced directives have demonstrated substantial benefits to patients, their families and caregivers, and the larger health-care system.➢ Despite these benefits, advanced care planning and advanced directives remain underutilized.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!