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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.
Kimura, Atsushi; Matsumoto, Yoshihiro; Wakata, Yoshifumi; Oyamada, Akiko; Ohishi, Masanobu; Fujiwara, Toshifumi; Ikuta, Ko; Tsuchiya, Kuniyoshi; Tayama, Naohisa; Tomari, Shinji; Miyahara, Hisaaki; Mae, Takao; Hara, Toshihiko; Saito, Taichi; Arizono, Takeshi; Kaji, Kozo; Mawatari, Taro; Fujiwara, Masami; Sakimura, Riku; Shin, Kunichika; Ninomiya, Kenichi; Nakaie, Kazutoshi; Antoku, Yasuaki; Tokunaga, Shoji; Nakashima, Naoki; Iwamoto, Yukihide; Nakashima, Yasuharu.
Afiliación
  • Kimura A; 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
  • Matsumoto Y; 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
  • Wakata Y; 2 Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
  • Oyamada A; 3 Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan.
  • Ohishi M; 4 Department of Orthopaedic Surgery, Chihaya Hospital, Fukuoka, Japan.
  • Fujiwara T; 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
  • Ikuta K; 5 Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Saga, Japan.
  • Tsuchiya K; 6 Department of Orthopaedic Surgery, JCHO Kyushu Hospital, Fukuoka, Japan.
  • Tayama N; 7 Department of Orthopaedic Surgery, Steel Memorial Yawata Hospital, Fukuoka, Japan.
  • Tomari S; 8 Department of Orthopaedic Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan.
  • Miyahara H; 9 Department of Orthopaedic Surgery, National Kyushu Medical Center, Fukuoka, Japan.
  • Mae T; 10 Department of Orthopaedic Surgery, Saga-ken Medical Center Koseikan, Saga, Japan.
  • Hara T; 11 Department of Orthopaedic Surgery, Aso Iizuka Hospital, Fukuoka, Japan.
  • Saito T; 12 Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan.
  • Arizono T; 13 Department of Orthopaedic Surgery, Kyushu Central Hospital, Fukuoka, Japan.
  • Kaji K; 14 Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan.
  • Mawatari T; 15 Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan.
  • Fujiwara M; 16 Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan.
  • Sakimura R; 17 Department of Orthopaedic Surgery, Harasanshin Hospital, Fukuoka, Japan.
  • Shin K; 18 Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Fukuoka, Japan.
  • Ninomiya K; 19 Department of Orthopaedic Surgery, Koga Hospital 21, Fukuoka, Japan.
  • Nakaie K; 20 Department of Orthopaedic Surgery, Fukuoka-Higashi Medical Center, Fukuoka, Japan.
  • Antoku Y; 21 Faculty of Medicine, Hospital Informatic Center, Oita University, Oita, Japan.
  • Tokunaga S; 22 Clinical Research Support Center Kyushu, Fukuoka, Japan.
  • Nakashima N; 23 Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
  • Iwamoto Y; 14 Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan.
  • Nakashima Y; 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
J Orthop Surg (Hong Kong) ; 27(3): 2309499019866965, 2019.
Article en En | MEDLINE | ID: mdl-31466509
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/m2 (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/m2, 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Actividades Cotidianas / Fragilidad / Fracturas de Cadera Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged80 / Female / Humans / Male País/Región como asunto: Asia Idioma: En Revista: J Orthop Surg (Hong Kong) Asunto de la revista: ORTOPEDIA Año: 2019 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Actividades Cotidianas / Fragilidad / Fracturas de Cadera Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged80 / Female / Humans / Male País/Región como asunto: Asia Idioma: En Revista: J Orthop Surg (Hong Kong) Asunto de la revista: ORTOPEDIA Año: 2019 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido