RESUMEN
Background and purpose - The association between mortality and lower extremity fractures (other than hip fractures in older individuals) is unclear. We therefore investigated mortality in adults of all ages after lower extremity fractures that required inpatient care. Patients and methods - Diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of patients admitted to the trauma ward at Central Finland Hospital were collected between 2002 and 2008 (n = 3,567). Patients were followed up until the end of 2012. Mortality rates were calculated for patients with all types of lower extremity fractures using data from the population at risk. Results - During the study, 2,081 women and 1,486 men sustained a lower extremity fracture. By the end of follow-up (mean duration 5 years), 42% of the women and 32% of the men had died. For all lower extremity fractures, the standardized mortality ratio (SMR) was 1.9 (95% CI: 1.8-2.0) for women and 2.6 (CI: 2.4-2.9) for men. In patients aged ≥65 years, mortality was increased and of similar magnitude after fractures of the hip, femoral diaphysis, and knee (distal femur, patella, and proximal tibia). In patients aged <65 years, mortality was increased after fractures at all sites. The SMR after fractures at different sites ranged between 2.1 (CI: 1.4-3.2) (ankle) and 6.7 (CI: 5.0-9.0) (hip) in patients aged <65 years and between 0.6 (CI: 0.30-1.1) (leg) and 2.2 (CI: 2.0-2.3) (hip) in patients aged ≥65 years. Interpretation - The post-fracture SMR of patients aged <65 years was at least double that of older patients. Furthermore, the higher mortality observed after proximal fractures of the lower extremity was greater in younger patients. The reasons behind these findings remain unclear.
Asunto(s)
Fracturas Óseas/mortalidad , Extremidad Inferior/lesiones , Medición de Riesgo/métodos , Factores de Edad , Anciano , Femenino , Finlandia/epidemiología , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Tasa de Supervivencia/tendencias , Factores de TiempoRESUMEN
BACKGROUND AND PURPOSE: Increased mortality after hip fracture is well documented. The mortality after hospitalization for upper extremity fracture is unknown, even though these are common injuries. Here we determined mortality after hospitalization for upper extremity fracture in patients aged ≥16 years. PATIENTS AND METHODS: We collected data about the diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of 5,985 patients admitted to the trauma ward of Central Finland Hospital between 2002 and 2008. During the study, 929 women and 753 men sustained an upper extremity fracture. The patients were followed up until the end of 2012. Mortality rates were calculated using data on the population at risk. RESULTS: By the end of follow-up (mean duration 6 years), 179 women (19%) and 105 men (14%) had died. The standardized mortality ratio (SMR) for all patients was 1.5 (95% CI: 1.4-1.7). The SMR was higher for men (2.1, CI: 1.7-2.5) than for women (1.3, CI: 1.1-1.5) (p < 0.001). The SMR decreased with advancing age, and the mortality rate was highest for men with humerus fractures. INTERPRETATION: In men, the risk of death related to proximal humerus fracture was even higher than that reported previously for hip fracture. Compared to the general population, the SMR was double for humerus fracture patients, whereas wrist fracture had no effect on mortality.
Asunto(s)
Fracturas Óseas/mortalidad , Extremidad Superior/lesiones , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Finlandia/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Fracturas del Húmero/mortalidad , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Factores de Riesgo , Fracturas del Hombro/mortalidad , Traumatismos de la Muñeca/mortalidad , Adulto JovenRESUMEN
BACKGROUND: The overall incidence of fractures has been addressed in several studies, but there are few data on different types of fractures that require inpatient care, even though they account for considerable healthcare costs. We determined the incidence of limb and spine fractures that required hospitalization in people aged ≥ 16 years. PATIENTS AND METHODS: We collected data on the diagnosis (ICD10 code), procedure code (NOMESCO), and 9 additional characteristics of patients admitted to the trauma ward of Central Finland Hospital between 2002 and 2008. Incidence rates were calculated for all fractures using data on the population at risk. RESULTS AND INTERPRETATION: During the study period, 3,277 women and 2,708 men sustained 3,750 and 3,030 fractures, respectively. The incidence of all fractures was 4.9 per 10(3) person years (95% CI: 4.8-5.0). The corresponding numbers for women and men were 5.3 (5.1-5.4) and 4.5 (4.3-4.6). Fractures of the hip, ankle, wrist, spine, and proximal humerus comprised two-thirds of all fractures requiring hospitalization. The proportion of ankle fractures (17%) and wrist fractures (9%) was equal to that of hip fractures (27%). Four-fifths of the hospitalized fracture patients were operated. In individuals aged < 60 years, fractures requiring hospitalization were twice as common in men as in women. In individuals ≥ 60 years of age, the opposite was true.