Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan

被引：14

作者：

Kimura, Atsushi ^{[1
]}

Matsumoto, Yoshihiro ^{[1
]}

Wakata, Yoshifumi ^{[2
]}

Oyamada, Akiko ^{[3
]}

Ohishi, Masanobu ^{[4
]}

Fujiwara, Toshifumi ^{[1
]}

Ikuta, Ko ^{[5
]}

Tsuchiya, Kuniyoshi ^{[6
]}

Tayama, Naohisa ^{[7
]}

Tomari, Shinji ^{[8
]}

Miyahara, Hisaaki ^{[9
]}

Mae, Takao ^{[10
]}

Hara, Toshihiko ^{[11
]}

Saito, Taichi ^{[12
]}

Arizono, Takeshi ^{[13
]}

Kaji, Kozo ^{[14
]}

Mawatari, Taro ^{[15
]}

Fujiwara, Masami ^{[16
]}

Sakimura, Riku ^{[17
]}

Shin, Kunichika ^{[18
]}

Ninomiya, Kenichi ^{[19
]}

Nakaie, Kazutoshi ^{[20
]}

Antoku, Yasuaki ^{[21
]}

Tokunaga, Shoji ^{[22
]}

Nakashima, Naoki ^{[23
]}

Iwamoto, Yukihide ^{[14
]}

Nakashima, Yasuharu ^{[1
]}

机构：

[1] Kyushu Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[2] Tokushima Univ, Inst Biomed Sci, Dept Med Informat, Grad Sch, Tokushima, Japan

[3] Saga Handicapped Childrens Hosp, Dept Orthopaed Surg, Saga, Japan

[4] Chihaya Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[5] Karatsu Red Cross Hosp, Dept Orthopaed Surg, Saga, Japan

[6] JCHO Kyushu Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[7] Steel Mem Yawata Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[8] Fukuoka Red Cross Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[9] Natl Kyushu Med Ctr, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[10] Saga Ken Med Ctr Koseikan, Dept Orthopaed Surg, Saga, Japan

[11] Aso Iizuka Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[12] Fukuoka City Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[13] Kyushu Cent Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[14] Kyushu Rosai Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[15] Hamanomachi Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[16] Sada Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[17] Harasanshin Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[18] Saiseikai Yahata Gen Hosp, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[19] Koga Hosp 21, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[20] Fukuoka Higashi Med Ctr, Dept Orthopaed Surg, Fukuoka, Fukuoka, Japan

[21] Oita Univ, Hosp Informat Ctr, Fac Med, Oita, Japan

[22] Clin Res Support Ctr Kyushu, Fukuoka, Fukuoka, Japan

[23] Kyushu Univ Hosp, Med Informat Ctr, Fukuoka, Fukuoka, Japan

来源：

JOURNAL OF ORTHOPAEDIC SURGERY | 2019年 / 27卷 / 03期

基金：

日本学术振兴会;

关键词：

activities of daily living; Barthel index; body mass index; frail elderly; hip fractures; mortality rate; osteoporosis; ELDERLY-PATIENTS; SHORT-TERM; IMPACT; RISK; COMORBIDITY; PREVALENCE; SARCOPENIA; SURGERY; TRENDS; OLDER;

D O I：

10.1177/2309499019866965

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, n = 45). Log-rank test revealed that previous fractures (p = 0.003), Barthel index (BI) at discharge (p = 0.011), and place-to-discharge (p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking (p = 0.007), length of hospital stay (LOS; p = 0.009), and BI (p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m(2) (HR 2.70, p = 0.023), TCCI >= 5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females. Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m(2), TCCI >= 5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.

引用

页数：8

共 23 条

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