García-Tercero Elisa, Belenguer-Varea Ángel, Villalon-Ruibio Daniela, López Gómez Jesús, Trigo-Suarez Rodrigo, Cunha-Pérez Cristina, Borda Miguel Germán, Tarazona-Santabalbina Francisco Jose
Geriatric Medicine Department, Hospital Universitario de la Ribera, Carretera de Corbera km. 1, 46600 Alzira, Spain.
School of Doctorate, Universidad Católica de Valencia San Vicente Mártir, 46001 Valencia, Spain.
Geriatrics (Basel). 2024 Apr 9;9(2):47. doi: 10.3390/geriatrics9020047.
: Hip fractures pose a significant challenge for older individuals given their high incidence and one-year mortality rate. The objective of this study was to identify the primary predictors of one-year mortality in older adults hospitalized for hip fractures. We conducted a retrospective cohort study involving adults aged 70 years or older who were admitted to the hospital for fragility hip fractures between 1 January 2014 and 31 December 2021. A total of 3229 patients were recruited, with 846 (26.2%) experiencing one-year mortality. Respiratory complications (HR 2.42, 95%CI 1.42-4.14; = 0.001) were the most significant predictors of one-year mortality, followed by hospital readmission (HR 1.96, 95%CI 1.66-2.32; < 0.001), the male sex (HR 1.88, 95%CI 1.46-2.32; < 0.001), cardiac complications (HR 1.88, 95%CI 1.46-2.32; < 0.001), and a diagnosis of dementia at admission (HR 1.37, 95%CI 1.13-1.66; = 0.001). The Charlson Index and the American Society of Anesthesiologists physical status classification system also significantly increased the mortality risk. Conversely, higher hemoglobin levels at admission and elevated albumin at discharge significantly reduced the mortality risk. The one-year mortality rate is substantial in older adults with hip fractures who are admitted to an orthogeriatric unit. The appropriate management of anemia, nutritional disorders, and comorbidity at admission and during the follow-up could potentially mitigate long-term mortality after hip fractures.
髋部骨折因其高发病率和一年死亡率,给老年人带来了重大挑战。本研究的目的是确定因髋部骨折住院的老年人一年死亡率的主要预测因素。我们进行了一项回顾性队列研究,纳入了2014年1月1日至2021年12月31日期间因脆性髋部骨折入院的70岁及以上成年人。共招募了3229名患者,其中846人(26.2%)在一年内死亡。呼吸并发症(HR 2.42,95%CI 1.42 - 4.14;P = 0.001)是一年死亡率最显著的预测因素,其次是再次入院(HR 1.96,95%CI 1.66 - 2.32;P < 0.001)、男性(HR 1.88,95%CI 1.46 - 2.32;P < 0.001)、心脏并发症(HR 1.88,95%CI 1.46 - 2.32;P < 0.001)以及入院时诊断为痴呆(HR 1.37,95%CI 1.13 - 1.66;P = 0.001)。查尔森指数和美国麻醉医师协会身体状况分类系统也显著增加了死亡风险。相反,入院时较高的血红蛋白水平和出院时升高的白蛋白水平显著降低了死亡风险。入住老年骨科病房的髋部骨折老年人的一年死亡率很高。入院时和随访期间对贫血、营养紊乱和合并症进行适当管理可能会降低髋部骨折后的长期死亡率。