scholarly journals Geriatric scores can predict long-term survival rate after hip fracture surgery

2019 ◽  
Author(s):  
Carmen da Casa ◽  
Carmen Pablos-Hernández ◽  
Alfonso González-Ramírez ◽  
José Miguel Julián-Enriquez ◽  
Juan F Blanco
Keyword(s):  
Hip Fracture ◽  
Survival Rate ◽  
Barthel Index ◽  
Charlson Index ◽  
Cumulative Survival Rate ◽  
Term Survival ◽  
Cumulative Survival ◽  
Hip Fracture Surgery ◽  
Katz Index ◽  
Fracture Surgery

Abstract Background: The management of hip fractures is nowadays mainly performed in Orthogeriatric Units, one of whose fundamental tools is the application of geriatric scores. The purpose of this study is to establish the potential usefulness of Barthel Index, Katz Index, Lawton-Brody Index and Physical Red Cross Scale geriatric scores as predictors of survival rate and readmission rate in older patients after hip fracture surgery. Methods: We designed a prospective single-center observational study, including 207 older adults over age 65 who underwent hip fracture surgery in the first half of 2014 and followed up to September 2018. Cumulative survival and readmission rates were analyzed by Kaplan-Meier; group comparison, by Log-Rank and hazard ratio, by Cox regression. Results: We found statistical differences (p<0.001) for cumulative survival rate by every geriatric score analyzed (BI HR=0.98 [0.97,0.99]; KI HR=1.24 [1.13-1.37]; LBI HR= 1.25 [1.16, 1.36]; PCRS HR=1.67 [1.37,2.04]). Furthermore, we could determinate an inflection point for survival estimation by Barthel Index (BI 0-55/60-100*, p<0.001, HR=2.37 [1.59,3.53]), Katz Index (KI A-B*/C-G, p<0.001, HR=2.66 [1.80, 3.93], and Lawton-Brody Index (LBI 0-3/4-8*, p<0.001, HR=3.40 [2.09,5.25]). We reveal a correlation of the Charlson Index (p=0.002) and Katz Index (p=0.041) with number of readmissions for the study period. Conclusions: The geriatric scores analyzed are related to the cumulative survival rate after hip fracture surgery for more than 4 years, independently of other clinical and demographic factors. Katz Index in combination with Charlson Index could also be a potential predictor of the number of readmissions after surgery for hip fracture patients.

scholarly journals Geriatric scores can predict long-term survival rate after hip fracture surgery

2019 ◽  
Author(s):  
Carmen da Casa ◽  
Carmen Pablos-Hernández ◽  
Alfonso González-Ramírez ◽  
José Miguel Julián-Enriquez ◽  
Juan F Blanco
Keyword(s):  
Hip Fracture ◽  
Survival Rate ◽  
Barthel Index ◽  
Charlson Index ◽  
Cumulative Survival Rate ◽  
Term Survival ◽  
Cumulative Survival ◽  
Hip Fracture Surgery ◽  
Katz Index ◽  
Fracture Surgery

Abstract Background The management of hip fractures is nowadays mainly performed in Orthogeriatric Units, one of whose fundamental tools is the application of geriatric scores. The purpose of this study is to establish the potential usefulness of Barthel Index, Katz Index, Lawton-Brody Index and Physical Red Cross Scale geriatric scores as predictors of survival rate and readmission rate in older patients after hip fracture surgery. Methods We designed a prospective single-center observational study, including 207 older adults over age 65 who underwent hip fracture surgery in the first half of 2014 and followed up to September 2018. Cumulative survival and readmission rates were analyzed by Kaplan-Meier; group comparison, by Log-Rank and hazard ratio, by Cox regression. Results We found statistical differences (p<0.001) for cumulative survival rate by every geriatric score analyzed (BI HR=0.98 [0.97,0.99]; KI HR=1.24 [1.13-1.37]; LBI HR=0.80 [0.74,0.87]; PCRS HR=1.67 [1.37,2.04]). Furthermore, we could determinate an inflection point for survival estimation by Barthel Index (BI 0-55/60-100*, p<0.001, HR=2.37 [1.59,3.53]), Katz Index (KI A-B/C-G*, p<0.001, HR=0.38 [0.26,0.56], and Lawton-Brody Index (LBI 0-3/4-8*, p<0.001, HR=3.40 [2.09,5.25]). We reveal a correlation of the Charlson Index (p=0.002) and Katz Index (p=0.041) with number of readmissions for the study period. Conclusions The geriatric scores analyzed are related to the cumulative survival rate after hip fracture surgery for more than 4 years, independently of other clinical and demographic factors. Katz Index in combination with Charlson Index could also be a potential predictor of the number of readmissions after surgery for hip fracture patients.

scholarly journals Geriatric scores as single-handed tools in the risk of 30-day mortality after hip fracture

2020 ◽  
Author(s):  
Carmen da Casa ◽  
Carmen Pablos-Hernández ◽  
Alfonso González-Ramírez ◽  
Juan F Blanco
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Barthel Index ◽  
Inflection Point ◽  
Binary Logistic Regression ◽  
High Energy ◽  
Red Cross ◽  
Hip Fracture Surgery ◽  
Katz Index ◽  
Fracture Surgery

Abstract Background The 30-day mortality rate after hip fracture surgery has been considered as an indirect indicator of the quality of care. This work aims to validate the Barthel Index, Katz Index, Lawton-Brody Index, and Physical Red Cross Scale analyzed in the Comprehensive Geriatric Assessment at admission as predictors of 30-day mortality after hip fracture surgery. Methods Prospective study including 899 hip fracture patients over 65. Bed-ridden, non- surgically treated patients, and high energy trauma or tumoral etiology fractures were excluded. Variables distribution were assessed by χ2, and we performed binary logistic regression for risk assessment. P < 0.05 was considered statistically significant. Results We noted a 30-day mortality rate of 5.9%. We related Barthel Index (OR = 0.986 [0.975–0.996], p = 0.010), Katz Index (OR per point = 1.254 [1.089–1.444], p = 0.002), Lawton-Brody Index (OR = 0.885 [0.788–0.992], p = 0.037), and Physical Red Cross Scale (OR = 1.483 [1.094–2.011], p = 0.011) with the 30-day mortality of patients after hip fracture surgery. We also validate the Barthel Index inflection point (0–55) (ORBI(0−55) = 2.428 [1.379–4.275], p = 0.002) and Katz Index inflection point (A-B) (ORKI(A−B) = 0.493 [0.273–0.891], p = 0.019) for the assessment of the highest risked patients. Conclusions The geriatric scores would be useful multifunctional tools in the assessment of hip fracture patients as singly predictors of 30-day mortality.

scholarly journals Geriatric scores can predict long-term survival rate after hip fracture surgery

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carmen da Casa ◽  
Carmen Pablos-Hernández ◽  
Alfonso González-Ramírez ◽  
José Miguel Julián-Enriquez ◽  
Juan F. Blanco
Keyword(s):  
Hip Fracture ◽  
Survival Rate ◽  
Term Survival ◽  
Long Term Survival ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

scholarly journals Factors influencing early and long-term survival following hip fracture among nonagenarians

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Laurence Weinberg ◽  
Bobby Ou Yang ◽  
Luka Cosic ◽  
Sarah Klink ◽  
Peter Le ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Postoperative Complications ◽  
Mortality Rate ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Term Survival ◽  
Hip Fracture Surgery ◽  
The Relationship ◽  
Fracture Surgery

Abstract Background The outcomes of nonagenarian patients undergoing orthopaedic surgery are not well understood. We investigated the 30-day mortality after surgical treatment of unilateral hip fracture. The relationship between postoperative complications and mortality was evaluated. Methods We performed a single-centre retrospective cohort study of nonagenarian patients undergoing hip fracture surgery over a 6-year period. Postoperative complications were graded according to the Clavien–Dindo classification. Correlation analyses were performed to evaluate the relationship between mortality and pre-specified mortality risk predictors. Survival analyses were assessed using Cox proportional hazards regression modelling. Results The study included 537 patients. The 30-day mortality rate was 7.4%. The mortality rate over a median follow-up period of 30 months was 18.2%. Postoperative complications were observed in 459 (85.5%) patients. Both the number and severity of complications were related to mortality (p < 0.001). Compared to patients who survived, deceased patients were more frail (p = 0.034), were at higher ASA risk (p = 0.010) and were more likely to have preoperative congestive heart failure (p < 0.001). The adjusted hazard ratio for mortality according to the number of complications was 1.3 (95% CI 1.1, 1.5; p = 0.003). Up to 21 days from admission, any increase in complication severity was associated significantly greater mortality [adjusted hazard ratio: 3.0 (95% CI 2.4, 3.6; p < 0.001)]. Conclusion In a nonagenarian cohort of patients undergoing hip fracture surgery, 30-day mortality was 7.4%, but 30-month mortality rates approached one in five patients. Postoperative complications were independently associated with a higher mortality, particularly when occurring early.

scholarly journals Delay to Surgery of Less Than 12 Hours Is Associated With Improved Short- and Long-Term Survival in Moderate- to High-Risk Hip Fracture Patients

2019 ◽  
Vol 10 ◽  
pp. 215145931985314 ◽  
Author(s):  
Markus T. Hongisto ◽  
Maria S. Nuotio ◽  
Tiina Luukkaala ◽  
Olli Väistö ◽  
Harri K. Pihlajamäki
Keyword(s):  
Adverse Effect ◽  
Hip Fracture ◽  
Living Arrangements ◽  
Great Influence ◽  
Term Survival ◽  
Long Term Survival ◽  
Hip Fracture Surgery ◽  
Short And Long Term ◽  
Fracture Surgery

Introduction: The effect of delays before surgery of 24 hours, 48 hours, and 72 hours on short- and long-term survival has been investigated comprehensively in hip fracture patients, but with controversial results. However, there is only limited evidence for how a threshold of 12-hour delay before hip fracture surgery affects survival. Materials and Methods: A prospective observational study of 884 consecutive hip fracture patients (age ≥ 65 years) undergoing surgery was carried out in terms of 30- and 365-day survival. A Cox hazard regression survival model was constructed for 724 patients with American Society of Anesthesiologists score ≥3 with adjustments of age, gender, cognition, number of medications on admission, hip fracture type, and prior living arrangements. Results: Patients who underwent surgery within 12 hours had better chances of survival than did those with 12 to 24 hours (hazard ratio [HR]: 8.30; 95% confidence interval [CI]: 1.13-61.4), 24 to 48 hours (HR: 7.21; 95% CI: 0.98-52.9), and >48 hours (HR: 11.75; 95% CI: 1.53-90.2) delay before surgery. Long-term survival was more influenced by nonadjustable patient features, but the adverse effect of >48 hours delay before surgery was noticed with HR: 2.02; 95% CI: 1.08-3.80. Increased age and male gender were significantly associated with worse short- and long-term survival. Discussion/Conclusions: Early hip fracture surgery within 12 hours of admission is associated with improved 30-day survival among patients with ASA score ≥3. Delay to surgery of more than 48 hours has an adverse effect on 365-day survival, but factors related to patients’ comorbidities have a great influence on long-term survival.

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