Author:
Li Xin-ping,Zhang Ping,Zhu Shi-wen,Yang Ming-hui,Wu Xin-bao,Jiang Xie-yuan
Abstract
Abstract
Introduction
The mortality rate after hip fracture is high. However, the 1-year mortality rate after femoral intertrochanteric fracture and femoral neck fracture differs (Gibson-Smith D, Klop C, Elders PJ, Welsing PM, van Schoor N, Leufkens HG, et al., Osteoporos Int 25:2555-2563, 2014), although both are types of hip fracture. A previous real-world single-center prospective cohort study showed that older age and high Charlson comorbidity index score were risk factors for femoral intertrochanteric fracture. Additionally, therapy with zoledronic acid 5 mg (Aclasta) was a protective factor (Li XP, Zhang P, Zhu SW, Yang MH, Wu XB, Jiang XY, J Orthop Surg Res. 16:727, 2021). We wished to determine the risk factors for all-cause mortality in femoral neck fracture patients.
Aim
To identify the risk factors for postoperative all-cause mortality in aged patients with femoral neck fracture.
Materials and methods
We enrolled 307 aged patients with femoral neck fracture; 38 were lost to follow-up after 2–3 years. The patients’ general characteristics, bone mineral density, and anti-osteoporosis treatment after operation were recorded as potential risk factors. Kaplan–Meier curves and multivariate Cox proportional hazards models were constructed to analyze the influence of each factor on all-cause mortality.
Results
This was a real-world single-center prospective cohort study showing that (1) most of the patients who died were male, older (mean age of the patients who died: 84.8 years vs. 77.9 years for survivors), and had more comorbidities compared with surviving patients. Previous fracture history, body mass index, femoral neck T score, hemoglobin and 25-hydroxy vitamin D levels did not differ significantly between patients who died vs. survived. (2) Differing from patients with intertrochanteric fractures, older patients with femoral neck fracture experienced no reduction in all-cause mortality with treatment with zoledronic acid.
Conclusion
In Chinese patients with femoral neck fracture, physicians should pay careful attention to male patients, older patients, and those with high numbers of comorbidities.
Funder
Beijing Municipal Administration of Hospitals Incubating Program
Beijing Municipal Health Committee Scientific Research Project
Capital’s Funds for Health Improvement and Research
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Rheumatology
Reference17 articles.
1. Nazrun AS, Tzar MN, Mokhtar SA, Mohamed IN. A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: Morbidity, subsequent fractures, and mortality. Ther Clin Risk Manag. 2014;10:937–48.
2. Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302:1573–9.
3. Klop C, Welsing PM, Cooper C, Harvey NC, Elders PJ, Bijlsma JW, et al. Mortality in British hip fracture patients,2000–2010: A population-based retrospective cohort study. Bone. 2014;66:171–7.
4. Frisch NB, Wessell N, Charters M, Greenstein A, Shaw J, Peterson E, Trent GS. Hip fracture mortality: differences between intertrochanteric and femoral neck fractures. J Surg Orthop Adv. 2018;27(1):64–71.
5. Van Heghe A, Mordant G, Dupont J, Dejaeger M, Laurent MR, Gielen E. Effects of Orthogeriatric Care Models on Outcomes of Hip Fracture Patients: A Systematic Review and Meta-Analysis. Calcif Tissue Int. 2022 Feb;110(2):162–84.