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Predictors of 10-year Mortality After Hip Fracture Surgery in a Pre-Pandemic Cohort. | LitMetric

Predictors of 10-year Mortality After Hip Fracture Surgery in a Pre-Pandemic Cohort.

Geriatr Orthop Surg Rehabil

Department of Orthopaedic Surgery, Singapore General Hosptial, Singapore.

Published: November 2023

AI Article Synopsis

  • Hip fractures pose serious health risks, leading to considerable mortality, and understanding long-term survival trends is crucial, especially as life expectancy increases in developed nations.
  • This study analyzed data from 766 Asian patients who had hip fracture surgery over a 10-year follow-up period, focusing on demographics and health conditions to identify factors impacting mortality.
  • Results showed a 10-year mortality rate of 61.6%, with the Age-adjusted Charlson comorbidity index (ACCI) correlating to mortality; major predictors at 10 years included end-stage renal failure, liver failure, and COPD, while cancer predicted mortality more prominently within the first year.

Article Abstract

Introduction: Though hip fractures are associated with significant mortality and morbidity, increasing life expectancy in developed countries necessitates an analysis of mortality trends and factors predicting long term survival. The aim of this study is to identify the predictors of 10-year mortality as well as assess the correlation of Age-adjusted Charlson comorbidity index (ACCI) with 10-year mortality in a surgically treated Asian geriatric hip fracture population.

Materials And Methods: From January 1, 2007 to December 31, 2009, 766 patients who underwent surgery for hip fracture with a minimum follow up of 10-years were recruited to the study (92% follow-up rate). A review of the patient's electronic hospital records was performed to glean the following data: patient demographics, pre-existing comorbidities, operation duration, length of stay, fracture configuration, as well as mortality data up to 10 years. CCI scores and individual co-morbidities were correlated with inpatient, 30-day, 1-year, 5-year and beyond 10-year mortality.

Results: Of the 766 patients, the mortality rate for 30-day, 1-year, 5-year and 10-years was 2.9%, 12.0%, 38.9% and 61.6% respectively. The average ACCI was 5.31. The 10-year mortality for patients with ACCI ≤ 3, ACCI 4-5 and ACCI ≥ 6 are 29.4%, 57.4% and 77.5% respectively. End-Stage-Renal Failure (ESRF), liver failure and COPD were dominant predictors of mortality at 10 years, whereas cancer was the predominant predictor at 1 year.

Discussion: ACCI significantly correlates with the 10-year mortality after surgically treated hip fractures with a shift of the dominant predictors from cancer to ESRF and COPD. This could inform future health policy and resource planning. This data also represents recently available pre-pandemic survival trends after hip fracture surgery and serves as a baseline for post-pandemic outcome surveillance of interventions for fragility fractures.

Conclusion: This study demonstrates that ACCI correlated with 10-year mortality after surgical treatment of hip fractures.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10655639PMC
http://dx.doi.org/10.1177/21514593231216558DOI Listing

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