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Citation
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Menéndez-Colino R, Alarcón T, Gotor P, Queipo R, Ramírez-Martín R, Otero A, González-Montalvo JI. Injury 2018; 49(3): 656-661. |
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Affiliation
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Department of Geriatric Medicine, Hospital Universitario la Paz, Paseo de la Castellana 261, 28046, Madrid, Spain; Instituto de Investigación Biomédica del Hospital Universitario La Paz (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain; Reticef, Spain; Department of Medicine, Universidad Autónoma de Madrid, Arzobiso Morcillo 4, 28029, Madrid, Spain. |
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Abstract
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INTRODUCTION: The aim of this study was to determine the patient characteristics that predict 1-year mortality after a hip fracture (HF).
METHODS: All patients admitted consecutively with fragility HF during 1 year in a co-managed orthogeriatric unit of a university hospital (FONDA cohort) were assesed. Baseline and admission demographic, clinical, functional, analytical and body-composition variables were collected in the first 72 h after admission. A protocol designed to minimize the consequences of the HF was applied. One year after the fracture patients or their carers were contacted by telephone to ascertain their vital status.
RESULTS: A total of 509 patients with a mean age of 85.6 years were included. One-year mortality was 23.2%. The final multivariate model included 8 independent mortality risk factors: age >85 years, baseline functional impairment in basic activities of daily living, low body mass index, cognitive impairment, heart disease, low hand-grip strength, anaemia at admission, and secondary hyperparathyroidism associated with vitamin D deficiency. The association of several of these factors greatly increased mortality risk, with an OR (95% confidence interval [CI]) of 5.372 (3.227-8.806) in patients with 4 to 5 factors, and an OR (95% CI) of 11.097 (6.432-19.144) in those with 6 or more factors.
CONCLUSIONS: In addition to previously known factors (such as age, impairment in basic activities of daily living, cognitive impairment, malnutrition and anaemia at admission), other factors, such as muscle strength and hyperparathyroidism associated with vitamin D deficiency, are associated with greater 1-year mortality after a HF.
Copyright © 2018 Elsevier Ltd. All rights reserved.
Language: en |