scholarly journals Impact of Sarcopenia on the Hip Fracture Treatment Outcomes: A Single-institution Case-control Study

2020 ◽  
Author(s):  
Hiroki Iida ◽  
Taisuke Seki ◽  
Yoshihito Sakai ◽  
Tsuyoshi Watanabe ◽  
Norimitsu Wakao ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hip Fracture ◽  
Treatment Outcomes ◽  
Hip Fractures ◽  
Proportional Hazards ◽  
Case Control Study ◽  
Discharge Rate ◽  
Cox Proportional Hazards ◽  
One Year ◽  
Control Study

Abstract Background: Although sarcopenia has been known as a risk factor for hip fractures, only a few reports have described the impact of sarcopenia on hip fracture treatment outcomes. The current study therefore sought to investigate the effect of sarcopenia on treatment outcomes of patients with hip fractures.Methods: This case–control study involved 337 patients (67 males and 270 females) with hip fractures aged ≥ years (mean age: 84.1 ± 7.1 years) who underwent surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. All patients were assessed for sarcopenia using dual-energy X-ray absorptiometry upon hospitalization. Treatment outcomes and one-year mortality rates were compared between patients with and without sarcopenia. Furthermore, we determined whether sarcopenia was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model.Results: The prevalence of sarcopenia in patients with hip fracture was 231(68.5%). Those with sarcopenia had a lower Barthel index (P < 0.0001) and hospital discharge rate (P = 0.035). Cox proportional hazards regression analysis adjusted for age and sex found that sarcopenia was a risk factor for one-year mortality (hazard ratio, 3.173, 95% confidence interval, 1.095–9.199, P = 0.033).Conclusions: Patients with hip fracture who had sarcopenia had a lower Barthel index, lower hospital discharge rate, and higher one-year mortality. Moreover, sarcopenia was identified as a risk factor for one-year mortality among those with hip fractures. The aforementioned findings may help clinicians better manage those with hip fracture.

scholarly journals Low muscle mass affect hip fracture treatment outcomes in older individuals: a single-institution case-control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hiroki Iida ◽  
Taisuke Seki ◽  
Yoshihito Sakai ◽  
Tsuyoshi Watanabe ◽  
Norimitsu Wakao ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hip Fracture ◽  
Treatment Outcomes ◽  
Muscle Mass ◽  
Barthel Index ◽  
Discharge Rate ◽  
Cox Proportional Hazards ◽  
Fracture Treatment ◽  
One Year ◽  
The Impact

Abstract Background Although sarcopenia has been known as a risk factor for hip fracture, only a few reports have described the impact of muscle mass on hip fracture treatment outcomes. The current study aimed to investigate the impact of muscle mass on hip fracture treatment outcomes. Methods This case–control study involved 337 patients (67 males and 270 females) with hip fracture aged ≥65 years (mean age: 84.1 ± 7.1 years) who underwent orthopedic surgery from January 2013 to June 2019. The mean follow-up period was 17.1 (1–60) months. Upon admission, all patients were assessed for low muscle mass according to the Asian Working Group for Sarcopenia criteria (male, SMI < 7.00 kg/m2; female, SMI < 5.40 kg/m2) using dual-energy X-ray absorptiometry. Treatment outcomes (stays at acute care institutions, hospital mortality, the Barthel index at discharge, and home discharge rates, and one-year mortality) were compared between patients with and without low muscle mass by Student’s t-test, Mann-Whitney U test and the Pearson Chi-Square test. A multivariate logistic regression model was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for factors related to low muscle mass. Kaplan–Meier survival curves on one-year mortality of hip fracture patients for those with and without low muscle mass were prepared, and log-rank tests were performed. Furthermore, we determined whether low muscle mass was a risk factor for one-year mortality in hip fracture patients using a Cox proportional hazards model. Results The prevalence of low muscle mass in patients with hip fracture was 231(68.5%). Those with low muscle mass had a lower Barthel index (P < 0.0001), hospital discharge rate (P = 0.035) and higher one-year mortality (P = 0.010). Cox proportional hazards regression analysis adjusted for age and sex found that low muscle mass was a risk factor for one-year mortality (hazard ratio, 3.182, 95% confidence interval, 1.097–9.226, P = 0.033). Conclusions Patients with hip fracture who had low muscle mass had a lower Barthel index, lower home discharge rate, and higher one-year mortality. Moreover, low muscle mass was identified as a risk factor for one-year mortality among those with hip fracture. The aforementioned findings may help clinicians better manage those with hip fracture.

PT05.4: Is Vitamin D Deficiency a Risk Factor for Hip Fracture? A Case-Control Study

2016 ◽  
Vol 35 ◽  
pp. S31-S32
Author(s):  
M.J. Martínez-Ramírez ◽  
C. Tenorio Jiménez ◽  
I. Carrillo-González ◽  
C. Arraiza Irigoyen ◽  
S. Salcedo Crespo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Hip Fracture ◽  
Vitamin D Deficiency ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

scholarly journals A case–control study of 30-day mortality in periprosthetic hip fractures and hip fractures

2020 ◽  
Vol 102 (3) ◽  
pp. 229-231
Author(s):  
T Jennnison ◽  
R Yarlagadda
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Control Study ◽  
Femoral Fractures ◽  
Periprosthetic Fractures ◽  
Power Calculation ◽  
Single Institution ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Control Study

Introduction There are increasing numbers of periprosthetic femoral fractures, which have high mortality rates. These fractures occur in a similar demographic to hip fractures. There has been limited research on mortality following these fractures. This study compared 30-day mortality in periprosthetic hip fractures with case-matched hip fractures. Materials and methods Case notes of periprosthetic hip fractures between 1 January 2009 and 31 December 2015 were reviewed retrospectively at a single institution. There were 173 periprosthetic hip fractures over the seven years of the study. All hip fractures attending the same institution have data collected prospectively for the National Hip Fracture Database. Data were analysed from the Hip Fracture Database. A power calculation was undertaken; 173 periprosthetic hip fractures were matched to 865 hip fractures individually for age, sex, American Society of Anesthesiologists grade and capacity. Results The median wait to surgery was 88 hours for periprosthetic fractures and 23 hours for hip fractures (p < 0.00001); 22.5% of patients with periprosthetic fractures underwent surgery within 36 hours compared with 68.2% of those with hip fractures (p < 0.0001). The median length of stay was 16 days for periprosthetic fractures and 10 days for hip fractures (p < 0.00001). The 30-day mortality was 6.4% for periprosthetic hip fractures and 3.1% for case-matched hip fractures (odds ratio 2.11, 95% confidence interval 1.03–4.36; p = 0.043). Conclusions Periprosthetic hip fractures have a significantly higher mortality than hip fractures. Further research should aim to improve outcomes in these patients.

Association between the use of benzodiazepines and opioids with the risk of falls and hip fractures in older adults

2017 ◽  
Vol 30 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Manuel E. Machado-Duque ◽  
Juan Pablo Castaño-Montoya ◽  
Diego A. Medina-Morales ◽  
Alejandro Castro-Rodríguez ◽  
Alexandra González-Montoya ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
Female Predominance ◽  
Risk Of Falls ◽  
Risk Of Fall ◽  
Control Study

ABSTRACTBackground:To determine the association between the use of opioids and benzodiazepines and the risk of falls with hip fracture in populations older than 65 years in Colombia.Methods:A case-control study with patients older than 65 years with diagnosis of hip fracture. Two controls were obtained per case. The drugs dispensed in the previous 30 days were identified. Sociodemographic, diagnostic, pharmacological (opioids and benzodiazepines), and polypharmacy variables were analyzed. A logistic regression model was used to analyze the risk of fall with hip fracture while using these drugs.Results:We included 287 patients with hip fractures and 574 controls. There was a female predominance (72.1%) and a mean age of 82.4 ± 8.0 years. Of the patients, 12.7% had been prescribed with opioids and 4.2% with benzodiazepines in the previous month. The adjusted multivariate analysis found that using opioids (OR:4.49; 95%CI:2.72–7.42) and benzodiazepines (OR:3.73; 95%CI:1.60–8.70) in the month prior to the event was significantly associated with a greater probability of suffering a fall with hip fracture.Conclusions:People who are taking opioids and benzodiazepines have increased risk for hip fracture in Colombia. Strategies to educate physicians regarding the pharmacology of older adults should be strengthened.

Evaluation of overactive bladder and nocturia as a risk factor for hip fracture in climacteric women: a matched pair case control study

2017 ◽  
Vol 38 (2) ◽  
pp. 252-256 ◽  
Author(s):  
Aysun Karabulut ◽  
Serap Simavlı ◽  
Ömer Demirtaş ◽  
Nusret Ök ◽  
Harun Reşit Güngör ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hip Fracture ◽  
Overactive Bladder ◽  
Case Control Study ◽  
Case Control ◽  
Matched Pair ◽  
Control Study

scholarly journals Association of Autoimmune Vasculitis and Incident Atrial Fibrillation: A Population‐Based Case‐Control Study

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Rowlens M. Melduni ◽  
Leslie T. Cooper ◽  
Bernard J. Gersh ◽  
Kenneth J. Warrington ◽  
Kent R. Bailey ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Proportional Hazards ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Case Control ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
New Diagnosis ◽  
Control Study

Background Recent investigations suggest that inflammation and autoimmunity might have a role in the pathophysiology of atrial fibrillation (AF). Given that abnormal ventriculovascular coupling often coexists with AF, we hypothesize that autoimmune vasculitis plays a significant role in the pathogenetic mechanism of AF. Methods and Results A standardized retrospective population‐based case–control study was conducted to evaluate the association between autoimmune vasculitis and AF, and all‐cause mortality. The study included 8459 patients with a new diagnosis of AF and 8459 age‐, sex‐, and registration calendar year–matched controls in Olmsted County, Minnesota, between January 1, 1980 and December 31, 2010. The association of each clinical characteristic, diagnosis, and treatment was assessed using conditional logistic regression to account for the matched case–control study design. Cox proportional hazards regression models and Kaplan‐Meier curves were used to detect independent predictors of mortality and examine cumulative survival. Of a total of 16 918 patients (mean age 72.3+14.4 years; 48.7% women), 320 (1.9%) were diagnosed with autoimmune vasculitis before the index date during the 30‐year period. Among the cases, the prevalence of any autoimmune vasculitis was 2.3%, whereas the frequency of autoimmune vasculitis in controls was 1.5% ( P <0.001). After adjusting for potential confounders, the odds of autoimmune vasculitis in AF cases was 1.5 times higher than in controls (odds ratio, 1.47; 95% CI, 1.04–2.01; P =0.03). Patients with AF and autoimmune vasculitis had worse 5‐year survival than those without autoimmune vasculitis or AF (44.7% versus 77.2%; log‐rank P <0.001). Conclusions Autoimmune vasculitis is significantly associated with AF and independently confers worse survival. These observations may represent one mechanism linking autoimmunity and inflammation to the pathogenesis and prognosis of AF.

Adherence With Bisphosphonates and Long-Term Risk of Hip Fractures: A Nested Case-Control Study Using Real-World Data

2017 ◽  
Vol 51 (9) ◽  
pp. 757-767 ◽  
Author(s):  
Varda Shalev ◽  
Sarah Sharman Moser ◽  
Inbal Goldshtein ◽  
Jingbo Yu ◽  
Clara Weil ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Control Study ◽  
Reference Group ◽  
Case Control ◽  
Bisphosphonate Therapy ◽  
Nested Case Control ◽  
Control Study

Background: Hip fracture is a major complication of osteoporosis. Bisphosphonate medication is the mainstay of treatment for osteoporosis. However, concerns have been raised regarding the effectiveness of bisphosphonates in reducing hip fracture risk after long-term use, particularly among patients with suboptimal adherence. Objective: To examine the association between adherence with bisphosphonate therapy and long-term risk of hip fracture. Methods: Included in the present nested case-control study were osteoporotic women (n = 14 357) who initiated bisphosphonate therapy in 2000-2010 and were retrospectively followed for incident hip fracture through November 2014. Within this cohort, each case of primary hip fractures was individually matched to 3 controls without a primary hip fracture. Proportion of follow-up days covered (PDC) with bisphosphonates was calculated from bisphosphonate purchases. Adherence was categorized into the following groups: purchase of 1 or 2 months’ supply (reference group), at least 3 months’ supply to PDC ≤20%, PDC >20% to ≤80%, PDC >80% to ≤100%. Results: Included in the analysis were 426 case-control groups with a mean age (SD) of 73.7 years (7.9). Compared with the reference group, PDC of 80% to 100% with bisphosphonates was associated with a significant reduction in hip fracture risk for patients with 8 to 15 years of follow-up (OR = 0.39; 95% CI = 0.18-0.87). Among patients with a follow-up of up to 3 years, OR was 0.58 (95% CI = 0.31-1.06). Conclusions: Adherence with bisphosphonates among osteoporotic patients is associated with lower risk of hip fracture, with no indication of diminished effectiveness with long-term use.

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