scholarly journals Fall Patterns Are Independent Risk Factors for Mortality After Hip Fracture in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A246-A246
Author(s):  
Namki Hong ◽  
Seungwon Burm ◽  
Yumie Rhee
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hip Fracture ◽  
Data Science ◽  
Major Health Problem ◽  
Mortality And Morbidity ◽  
Severance Hospital ◽  
Weight Shift ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Hip fracture is becoming a major health problem with high mortality and morbidity in older adults. However, whether specific fall patterns could act as independent risk factors for predicting mortality after hip fracture remains unknown. We aimed to investigate whether fall patterns can serve as an independent risk factor for mortality after hip fracture. Electronic medical records (EMR) of individuals who visited emergency room or admitted to the Severance hospital, Seoul, Korea, between January 2005 to December 2019 were reviewed to categorize fall patterns. Fall patterns were categorized upon review of explanatory description in EMR, using modified classification based on motion analysis of video-captured falls in a prior study. Among 1,991 study subjects (mean age 77 years, 71% women), 211 patients died (10.6%; median survival 296 days). Fall location was divided into home (67.4%) and outdoor (32.6%) with mortality rate of 11.9% and 8.0% (p=0.009), respectively. Fall patterns were specified by “cause of fall” (6 categories; slip [29.6%], trip or stumble [17.5%], etc.) and by “activity at time of fall” (6 categories; walking [54.8%], getting up or rising [14.1%], etc). Among the combinations of both causes and activities, individuals who sustained hip fracture during “incorrect weight shift while sitting down or lowering”(hazard ratio [HR] 3.35, p=0.003), “collapsed during unclassified activity”(HR 2.37, p=0.006), “incorrect weight shift while getting up or rising”(HR 2.13, p=0.003), and “slipped while walking”(HR 1.83, p=0.004) had increased mortality after hip fracture compared to those with outdoor falls, after adjustment for age, sex, and Charlson comorbidity index. Specific fall patterns in individuals who sustained hip fracture predicted excess mortality in older adults, independent of age, sex, and comorbidities. Acknowledgement: We thank Doori Cho of the the SENTINEL (Severance ENdocrinology daTa scIeNcE pLatform) team (4-2018-1215) for the data acquisition process. Conflict of Interest: SB, NH, and YR have nothing to declare.

scholarly journals Sarcopenia and Charlson Comorbidity Index are Risk Factors for Short-Term Postoperative Prognosis of Elderly Patients with Gastrointestinal Tumor: A Retrospective Study

2021 ◽  
Author(s):  
Jiaqiu Wang ◽  
Liqian Xu ◽  
Shunmei Huang ◽  
Quan Hui ◽  
Xuexue Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Charlson Comorbidity Index ◽  
Older Patients ◽  
Gastrointestinal Tumor ◽  
Short Term ◽  
Postoperative Prognosis ◽  
History Of ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Background Sarcopenia is one of the most common syndromes in the older adults. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of sarcopenia in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between sarcopenia and short-term postoperative prognosis.Method A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate sarcopenia. Short-term postoperative complications and length of stay were considered as short-term outcome of this study.Results Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of sarcopenia, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of sarcopenia. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Sarcopenia and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in the elderly with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay.ConclusionsSarcopenia and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.

scholarly journals Low muscle mass and Charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiaqiu Wang ◽  
Liqian Xu ◽  
Shunmei Huang ◽  
Quan Hui ◽  
Xuexue Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Muscle Mass ◽  
Charlson Comorbidity Index ◽  
Older Patients ◽  
Gastrointestinal Tumor ◽  
Short Term ◽  
History Of ◽  
Comorbidity Index ◽  
Independent Risk Factors

Abstract Background Sarcopenia is one of the most frequent syndromes in older adults and one of its main characteristics is low muscle mass. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of low muscle mass in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between low muscle mass and short-term postoperative prognosis. Method A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate low muscle mass. Short-term postoperative complications and length of stay were considered as short-term outcomes of this study. Results Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of low muscle mass, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of low muscle mass. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Low muscle mass and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in older adults with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay. Conclusions Low muscle mass and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.

scholarly journals Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Cheng Bian ◽  
Xiao Kang Cheng ◽  
Yong Sheng An
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
Multivariate Logistic Regression ◽  
Preoperative Risk ◽  
Hip Fracture Surgery ◽  
Preoperative Risk Factors ◽  
Independent Risk Factors ◽  
Fracture Surgery

Abstract Background This study aimed to explore the preoperative risk factors related to blood transfusion after hip fracture operations and to establish a nomogram prediction model. The application of this model will likely reduce unnecessary transfusions and avoid wasting blood products. Methods This was a retrospective analysis of all patients undergoing hip fracture surgery from January 2013 to January 2020. Univariate and multivariate logistic regression analyses were used to evaluate the association between preoperative risk factors and blood transfusion after hip fracture operations. Finally, the risk factors obtained from the multivariate regression analysis were used to establish the nomogram model. The validation of the nomogram was assessed by the concordance index (C-index), the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curves. Results A total of 820 patients were included in the present study for evaluation. Multivariate logistic regression analysis demonstrated that low preoperative hemoglobin (Hb), general anesthesia (GA), non-use of tranexamic acid (TXA), and older age were independent risk factors for blood transfusion after hip fracture operation. The C-index of this model was 0.86 (95% CI, 0.83–0.89). Internal validation proved the nomogram model’s adequacy and accuracy, and the results showed that the predicted value agreed well with the actual values. Conclusions A nomogram model was developed based on independent risk factors for blood transfusion after hip fracture surgery. Preoperative intervention can effectively reduce the incidence of blood transfusion after hip fracture operations.

scholarly journals Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Older Age ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

Incidence And Risk Factors For Postoperative Pneumonia Following Surgically Treated Hip Fracture In Geriatric Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yunxu Tian ◽  
Yanbin Zhu ◽  
Kexin Zhang ◽  
Miao Tian ◽  
Shuhui Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Multivariate Analyses ◽  
Postoperative Pneumonia ◽  
Multivariate Logistic Regression Model ◽  
Preventive Strategy ◽  
Tertiary Referral Center ◽  
Independent Risk Factors ◽  
Clinical Conditions

Abstract Objective: Large sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.Methods: A retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.Results: This study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.7%. In the multivariate analyses, age (OR, 1.04; 95% CI, 1.02–1.06), sex (males) (OR, 2.27; 95% CI, 1.64-3.13), respiratory disease (OR, 3.74; 95% CI, 2.32–6.04), heart disease (OR, 1.68; 95% CI, 1.14–2.47), cerebrovascular disease (OR, 1.58; 95% CI, 1.11–2.27), liver disease (OR, 2.61; 95% CI, 1.33–5.15), preoperative stay (OR, 1.08; 95% CI, 1.05–1.11) and general anesthesia (OR, 1.61; 95% CI, 1.15-2.27) were identified as independent risk factors for postoperative pneumonia.Conclusions: This study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reductionof postoperative pneumonia.

scholarly journals ADVANCING AN INTERDISCIPLINARY SCIENCE OF AGING THROUGH A PRACTICE-BASED DATA SCIENCE APPROACH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S480-S480
Author(s):  
Robert Lucero ◽  
Ragnhildur Bjarnadottir
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Older Adults ◽  
Text Mining ◽  
Language Processing ◽  
Fall Risk ◽  
Data Science ◽  
Care Quality ◽  
Science Approach ◽  
Hospitalized Older Adults

Abstract Two hundred and fifty thousand older adults die annually in United States hospitals because of iatrogenic conditions (ICs). Clinicians, aging experts, patient advocates and federal policy makers agree that there is a need to enhance the safety of hospitalized older adults through improved identification and prevention of ICs. To this end, we are building a research program with the goal of enhancing the safety of hospitalized older adults by reducing ICs through an effective learning health system. Leveraging unique electronic data and healthcare system and human resources at the University of Florida, we are applying a state-of-the-art practice-based data science approach to identify risk factors of ICs (e.g., falls) from structured (i.e., nursing, clinical, administrative) and unstructured or text (i.e., registered nurse’s progress notes) data. Our interdisciplinary academic-clinical partnership includes scientific and clinical experts in patient safety, care quality, health outcomes, nursing and health informatics, natural language processing, data science, aging, standardized terminology, clinical decision support, statistics, machine learning, and hospital operations. Results to date have uncovered previously unknown fall risk factors within nursing (i.e., physical therapy initiation), clinical (i.e., number of fall risk increasing drugs, hemoglobin level), and administrative (i.e., Charlson Comorbidity Index, nurse skill mix, and registered nurse staffing ratio) structured data as well as patient cognitive, environmental, workflow, and communication factors in text data. The application of data science methods (i.e., machine learning and text-mining) and findings from this research will be used to develop text-mining pipelines to support sustained data-driven interdisciplinary aging studies to reduce ICs.

Risk Factors for Hip Fracture Sites and Mortality in Older Adults

2011 ◽  
Vol 71 (1) ◽  
pp. 191-197 ◽  
Author(s):  
Wei-Peng Lin ◽  
Chiung-Jung Wen ◽  
Ching-Chuan Jiang ◽  
Sheng-Mou Hou ◽  
Ching-Yu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hip Fracture

scholarly journals Evaluation of Nottingham Hip Fracture Score, Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity as predictors of mortality in elderly neck of femur fracture patients

2020 ◽  
Vol 8 ◽  
pp. 205031212091826 ◽  
Author(s):  
Michael James Nelson ◽  
Justin Scott ◽  
Palvannan Sivalingam
Keyword(s):  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Mortality Prediction ◽  
Mortality And Morbidity ◽  
Operative Severity Score ◽  
Significant Difference ◽  
Comorbidity Index ◽  
Operating Characteristic Curve

Background: This study evaluated the use of several risk prediction models in estimating short- and long-term mortality following hip fracture in an Australian population. Methods: Data from 195 patients were retrospectively analysed and applied to three models of interest: the Nottingham Hip Fracture Score, the Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity. The performance of these models was assessed with receiver operating characteristic curve as well as logistic regression modelling. Results: The median age of participants was 83 years and 69% were women. Ten percent of patients were deceased by 30 days, 25% at 6 months and 31% at 12 months post-operatively. While there was no statistically significant difference between the models, the Age-Adjusted Charlson Comorbidity Index had the largest area under the receiver operating characteristic curve for within 30 day and 12 month mortality, while the Nottingham Hip Fracture Score was largest for 6-month mortality. There was no evidence to suggest that the models were selecting a specific subgroup of our population, therefore, no indication was present to suggest that using multiple models would improve mortality prediction. Conclusions: While there was no statistically significant difference in mortality prediction, the Nottingham Hip Fracture Score is perhaps the best suited clinically, due to its ease of implementation. Larger prospective data collection across a variety of sites and its role in guiding clinical management remains an area of interest.

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