Is dynamic locking plate(Targon FN) a better choice for treating of intracapsular hip fracture? A meta-analysis

Background: Osteoporosis presents a major threat to the health of women older than 65 years. Bisphosphonates (BPs) are now the principal class of medications for osteoporosis. Objective: To evaluate the efficacy and safety of BPs in women older than 65 years. Methods: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was undertaken for randomized controlled trials (RCTs) on the efficacy and safety of BPs in women older than 65 years. The primary outcome measures were the change in bone mass density (BMD), serum bone turnover marker levels, fracture rate and the adverse effect (AE) rate. The final search was performed in August 2019. Results: Seven RCTs were included. A total of 23287 patients met the inclusion criteria. BPs significantly increased the BMD of the posteroanterior (PA) spine, lateral spine and femoral neck, and reduced the fracture, vertebrate fracture and hip fracture rates in women older than 65 years. In addition, BPs increased the risks for pyrexia, myalgia, arthralgia, headache and influenza-like symptoms and had no statistical effect on any AEs, any serious AEs, discontinuation due to AEs, oesophagitis, any upper gastrointestinal adverse event, atrial fibrillation and myocardial infarction occurrence in women older than 65 years. Finally, intravenous BPs reduced hip fracture risk but increased AEs in women older than 65 years. Conclusion: Despite the fact that AEs significantly increased after drug delivery, BPs are highly effective and safe for managing osteoporosis in women older than 65 years. Zoledronic acid caused an increased rate of AEs in women older than 65 years, but these AEs seemed to be mild to moderate. In addition, the hip fracture rate in women older than 80 years old treated with BPs was different than that in the other included patients. Therefore, doctors may prescribe BPs for women older than 65 years in order to increase BMD, and AEs and hip fractures in women older than 80 years should be given attention.

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Effects of β-Cryptoxanthin on Improvement in Osteoporosis Risk: A Systematic Review and Meta-Analysis of Observational Studies

Foods ◽

10.3390/foods10020296 ◽

2021 ◽

Vol 10 (2) ◽

pp. 296

Author(s):

Sun Jo Kim ◽

Nguyen Hoang Anh ◽

Nguyen Co Diem ◽

Seongoh Park ◽

Young Hyun Cho ◽

...

Keyword(s):

Systematic Review ◽

Hip Fracture ◽

Bone Health ◽

Observational Studies ◽

Meta Analysis ◽

Random Effects Model ◽

High Intake ◽

Quantitative Evidence ◽

Osteoporosis Risk ◽

Reduced Risk

Many studies have analyzed the effects of β-cryptoxanthin (BCX) on osteoporosis and bone health. This systematic review and meta-analysis aimed at providing quantitative evidence for the effects of BCX on osteoporosis. Publications were selected and retrieved from three databases and carefully screened to evaluate their eligibility. Data from the final 15 eligible studies were extracted and uniformly summarized. Among the 15 studies, seven including 100,496 individuals provided information for the meta-analysis. A random effects model was applied to integrate the odds ratio (OR) to compare the risk of osteoporosis and osteoporosis-related complications between the groups with high and low intake of BCX. A high intake of BCX was significantly correlated with a reduced risk of osteoporosis (OR = 0.79, 95% confidence interval (CI) 0.70–0.90, p = 0.0002). The results remained significant when patients were stratified into male and female subgroups as well as Western and Asian cohorts. A high intake of BCX was also negatively associated with the incidence of hip fracture (OR = 0.71, 95% CI 0.54–0.94, p = 0.02). The results indicate that BCX intake potentially reduces the risk of osteoporosis and hip fracture. Further longitudinal studies are needed to validate the causality of current findings.

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Modifiable lifestyle factors associated with fragility hip fracture: a systematic review and meta-analysis

Journal of Bone and Mineral Metabolism ◽

10.1007/s00774-021-01230-5 ◽

2021 ◽

Author(s):

Sharri J. Mortensen ◽

Indeevar Beeram ◽

Jonathon Florance ◽

Kaveh Momenzadeh ◽

Amin Mohamadi ◽

...

Keyword(s):

Systematic Review ◽

Hip Fracture ◽

Meta Analysis ◽

Lifestyle Factors ◽

Fragility Hip Fracture ◽

Factors Associated ◽

Modifiable Lifestyle Factors

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Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

Scientific Reports ◽

10.1038/s41598-021-89617-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Firas J. Raheman ◽

Djamila M. Rojoa ◽

Jvalant Nayan Parekh ◽

Reshid Berber ◽

Robert Ashford

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Case Fatality Rate ◽

Excess Mortality ◽

Meta Analysis ◽

Case Fatality ◽

Pooled Analysis ◽

Fatality Rate ◽

Increased Risk ◽

The Impact

AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.

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Sernbo score predicts survival after intracapsular hip fracture in the elderly

Annals of The Royal College of Surgeons of England ◽

10.1308/003588413x13511609954653 ◽

2013 ◽

Vol 95 (1) ◽

pp. 29-33 ◽

Cited By ~ 20

Author(s):

EJC Dawe ◽

E Lindisfarne ◽

T Singh ◽

I McFadyen ◽

P Stott

Keyword(s):

Hip Fracture ◽

High Risk ◽

Risk Group ◽

Characteristic Curve ◽

Social Situation ◽

High Risk Group ◽

Low Risk ◽

Risk Of Death ◽

Intracapsular Hip Fracture ◽

The Mean

Introduction The Sernbo score uses four factors (age, social situation, mobility and mental state) to divide patients into a high-risk and a low-risk group. This study sought to assess the use of the Sernbo score in predicting mortality after an intracapsular hip fracture. Methods A total of 259 patients with displaced intracapsular hip fractures were included in the study. Data from prospectively generated databases provided 22 descriptive variables for each patient. These included operative management, blood tests and co-mobidities. Multivariate analysis was used to identify significant predictors of mortality. Results The mean patient age was 85 years and the mean follow-up duration was 1.5 years. The one-year survival rate was 92% (±0.03) in the low-risk group and 65% (±0.046) in the high-risk group. Four variables predicted mortality: Sernbo score >15 (p=0.0023), blood creatinine (p=0.0026), ASA (American Society of Anaesthesiologists) grade >3 (p=0.0038) and non-operative treatment (p=0.0377). Receiver operating characteristic curve analysis showed the Sernbo score as the only predictor of 30-day mortality (area under curve 0.71 [0.65–0.76]). The score had a sensitivity of 92% and a specificity of 51% for prediction of death at 30 days. Conclusions The Sernbo score identifies patients at high risk of death in the 30 days following injury. This very simple score could be used to direct extra early multidisciplinary input to high-risk patients on admission with an intracapsular hip fracture.

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