Rosinés Maria Dolors, Castejón Mercè, Espaulella-Panicot Joan, Arnau Anna
Department of Orthopedic Surgery and Traumatology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain.
Doctoral Program in Medicine and Biomedical Sciences, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain.
Arch Osteoporos. 2025 Jul 16;20(1):99. doi: 10.1007/s11657-025-01585-6.
Fragility hip fractures significantly impact long-term survival in patients over 65 years. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. Advanced age, male sex, and cognitive/functional impairment increased mortality. Comprehensive assessments are essential for personalized treatment.
Fragility hip fractures are increasing due to population aging. The main objective of this study was to determine long-term survival and the probability of dying from hip fracture or from other causes in patients over 65 years old who underwent surgery for a fragility hip fracture.
A retrospective cohort study was conducted between June 2010 and December 2021. The main outcomes were overall survival, relative survival, and the probability of dying either from hip fracture or from other causes at 1, 5, and 10 years after surgery determined with the WebSurvCa application.
A total of 2646 patients were included with a median age of 86.3 years [81.7-90.3]; 75% were women. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. The cumulative probability of dying from a hip fracture was 17.2%, 35.4%, and 49.4% at 1, 5, and 10 years, respectively. Factors such as advanced age, male sex, and prior functional or cognitive deterioration were associated with worse long-term survival. In patients over 85 years old, without functional dependence or with normal cognitive status, the probability of dying from other causes at 5 and 10 years exceeded that of dying from the hip fracture.
Our results highlight that long-term mortality in these patients is high, persisting even 10 years after the fracture. Comprehensive evaluation considering age, functional, and cognitive status is essential in order to predict outcomes and personalize treatment strategies.
髋部脆性骨折对65岁以上患者的长期生存有显著影响。1年、5年和10年的总生存率分别为76.0%（95%置信区间74.4 - 77.7）、37.7%（95%置信区间35.6 - 39.9）和11.9%（95%置信区间9.6 - 14.8）。高龄、男性以及认知/功能障碍会增加死亡率。全面评估对于个性化治疗至关重要。
由于人口老龄化，髋部脆性骨折的发生率正在上升。本研究的主要目的是确定65岁以上因髋部脆性骨折接受手术的患者的长期生存率以及死于髋部骨折或其他原因的概率。
在2010年6月至2021年12月期间进行了一项回顾性队列研究。主要结局是通过WebSurvCa应用程序确定的术后1年、5年和10年的总生存率、相对生存率以及死于髋部骨折或其他原因的概率。
共纳入2646例患者，中位年龄为86.3岁[81.7 - 90.3]；75%为女性。1年、5年和10年的总生存率分别为76.0%（95%置信区间74.4 - 77.7）、37.7%（95%置信区间35.6 - 39.9）和11.9%（95%置信区间9.6 - 14.8）。1年、5年和10年死于髋部骨折的累积概率分别为17.2%、35.4%和49.4%。高龄、男性以及既往功能或认知功能恶化等因素与较差的长期生存相关。在85岁以上无功能依赖或认知状态正常的患者中，5年和10年死于其他原因的概率超过死于髋部骨折的概率。
我们的结果表明，这些患者的长期死亡率很高，甚至在骨折后10年仍持续存在。考虑年龄、功能和认知状态的全面评估对于预测结局和制定个性化治疗策略至关重要。
