Abstract:
:Hip fractures are common in elderly people. Despite great progress in surgical care, the outcomes of these patients remain disappointing. This study determined pre-fracture hospital admission as a prognostic variable for inferior functional outcomes and increased mortality rates in the perioperative phase and in the first postoperative year. PURPOSE:The influence of a pre-fracture hospitalization on outcomes in hip fracture patients has not yet been investigated. METHODS:Four hundred two patients who were surgically treated for hip fracture were prospectively enrolled. Patients with a hospital stay within the last 3 months prior to a hip fracture were compared to patients without a pre-fracture hospitalization. Postoperative functional outcomes and mortality rates were compared between groups at the time of hospital discharge and additionally at the six- and twelve-month follow-up appointments. A multivariate regression analysis was performed. RESULTS:A pre-fracture hospitalization was reported by 67 patients (17%). In 63% of cases, patients were admitted due to non-surgical, general medical conditions. In 37% of cases, patients were treated due to a condition related to a surgical subject. In the multivariate analysis, pre-fracture hospitalization was an independent risk factor for reduced values on the Barthel Index at 6 months after surgery (B, -9.918; 95%CI of B, -19.001--0.835; p = 0.032) and on the Tinetti Test at 6 months (B, -2.914; 95%CI of B, -1.992--0.047; p = 0.047) and 12 months after surgery (B, -4.680; 95%CI of B, -8.042--1.319; p = 0.007). Pre-fracture hospitalization was additionally associated with increased mortality rates at 6 months (OR 1.971; 95%CI 1.052-3.693; p = 0.034) and 12 months after surgery (OR 1.888; 95%CI 1.010-9.529; p = 0.046). CONCLUSIONS:Hip fracture patients with a recent pre-fracture hospital admission are at a substantial risk for inferior functional outcomes and increased mortality rates not only in the perioperative phase but also in the first postoperative year. As a simple dichotomous variable, pre-fracture hospitalization might be a suitable tool for future geriatric hip fracture screening instruments.
journal_name
Arch Osteoporosjournal_title
Archives of osteoporosisauthors
Aigner R,Buecking B,Hack J,Eschbach D,Oberkircher L,Ruchholtz S,Bliemel Cdoi
10.1007/s11657-017-0327-2subject
Has Abstractpub_date
2017-12-01 00:00:00pages
32issue
1eissn
1862-3522issn
1862-3514pii
10.1007/s11657-017-0327-2journal_volume
12pub_type
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journal_title:Archives of osteoporosis
pub_type: 已发布勘误,撤回出版物
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:Archives of osteoporosis
pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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