scholarly journals Osteoporotic Hip Fractures in the Elderly: Is there a Gender Difference?

2021 ◽  
Author(s):  
Sharifah Aishah Wan ◽  
Ing Khieng Tiong ◽  
Seow Lin Chuah ◽  
Yaw Kiet Cheong ◽  
Benjamin Sachdev Manjit Singh ◽  
...  
Keyword(s):  
Hip Fracture ◽  
General Hospital ◽  
Hip Fractures ◽  
Statistical Significance ◽  
Secondary Osteoporosis ◽  
Major Public Health Problem ◽  
Thyroid Disorder ◽  
Men And Women ◽  
Osteoporotic Hip Fracture ◽  
The Mean

Abstract BackgroundOsteoporosis and osteoporotic fracture pose a major public health problem in our aging population. Osteoporotic hip fractures carry an increased morbidity and mortality, with some difference seen between men and women. While overall diagnosis and treatment for osteoporosis have improved, osteoporosis in men remain underdiagnosed and undertreated.AimWe aim to describe the difference in clinical characteristics between elderly men and women with osteoporotic hip fractures in Sarawak General Hospital.MethodsAll patients diagnosed with osteoporotic hip fracture admitted to Sarawak General Hospital from June 2019-March 2021 were recruited and demographic data and clinical features were obtained.ResultsThere were 140 patients with osteoporotic hip fracture, and 40 were men (28.6%). The mean age for males were 74.1 ± 9.5 years, while the mean age for females were 77.4 ± 9.1 years (p=0.06). The types of fracture consisted of neck of femur=78, intertrochanteric=61, and subtrochanteric=1. There were 20 men with secondary osteoporosis (50%), while 13 women (13%) had secondary osteoporosis (p<0.001). The causes of secondary osteoporosis among the men were hypogonadism, COPD, GIOP, renal disease, ADT, thyroid disorder, prostate cancer, and previous gastrectomy. There were two deaths among the men and four deaths among the women during the inpatient and 3 months follow up period. There was no statistical significance between the mortality rates between male patients (5%) and female patients (4%) (p=0.55). ConclusionThere were more females with osteoporotic hip fractures, and there were significantly more males with secondary osteoporotic hip fractures.Trial registration: This study (Male osteoporotic hip fracture in Sarawak General Hospital) was registered with the Malaysian National Medical Research Register (NMRR). Trial registration number: NMRR-19-323-46068 IIR

scholarly journals The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Hospital Admissions ◽  
The Elderly ◽  
Primary Outcome Measure ◽  
Time To Death ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

scholarly journals Design and biomechanical study of slide-poking external fixator for hip fracture

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052095093
Author(s):  
Hua-Biao Chen ◽  
Hong-Bo Wu ◽  
Min Chen ◽  
Yu-Liang Huang
Keyword(s):  
Hip Fracture ◽  
Femoral Head ◽  
Hip Fractures ◽  
External Fixator ◽  
Dynamic Hip Screw ◽  
Control Groups ◽  
Vertical Loading ◽  
Hip Screw ◽  
The Mean ◽  
And Control

Background Femoral head collapse and coxa vara lead to internal fixator failure in elderly patients with hip fracture. External fixator application is an optimal choice; however, the existing methods have many disadvantages. Methods Type 31-A1.3 hip fracture models were developed in nine pairs of 1-year-old fresh bovine corpse femur specimens. Each left femur specimen was fixed by a dynamic hip screw (control group), and each right femur specimen was fixed by the slide-poking external fixator (experimental group). Vertical loading and torsion tests were then performed in both groups. Results In the vertical loading experiment, a 1000-N load was implemented. The mean vertical downward displacement of the femoral head in the experimental and control groups was 1.49322 ± 0.116280 and 2.13656 ± 0.166374 mm, respectively. In the torsion experiment, when the torsion was increased to 10.0 Nm, the mean torsion angle in the experimental and control groups was 7.9733° ± 1.65704° and 15.4889° ± 0.73228°, respectively. The slide-poking external fixator was significantly more resistant to compression and rotation than the dynamic hip screw. Conclusion The slide-poking external fixator for hip fractures that was designed and developed in this study can provide sufficient stability to resist compression and rotation in hip fractures.

scholarly journals Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kuang-Ting Yeh ◽  
Tzai-Chiu Yu ◽  
Ru-Ping Lee ◽  
Jen-Hung Wang ◽  
Kuan-Lin Liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatic Encephalopathy ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Human Life ◽  
National Database ◽  
Research Database ◽  
Older Individuals ◽  
Osteoporotic Hip Fracture ◽  
Increased Risk

Abstract Background Osteoporotic hip fracture is a common general health problem with a significant impact on human life because it debilitates the patients and largely decreases their quality of life. Early prevention of fractures has become essential in recent decades. This can be achieved by evaluating the related risk factors, as a reference for further intervention. This is especially useful for the vulnerable patient group with comorbidities. Hepatic encephalopathy (HE), a major complication of liver cirrhosis, may increase the rate of falls and weaken the bone. This study evaluated the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged population using a national database. Methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We included people who were older than 50 years with hepatic encephalopathy or other common chronic illnesses. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of osteoporotic hip fracture between the both cohorts were calculated using Cox proportional hazard regression models. Results The mean age of the enrolled patients was 66.5 years. The incidence ratio of osteoporotic hip fracture in the HE group was significantly higher than that in the non-HE group (68/2496 [2.7%] vs 98/9984 [0.98%]). Patients with HE were 2.15-times more likely to develop osteoporotic hip fractures than patients without HE in the whole group. The risk ratio was also significantly higher in female and older individuals. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer, and depression. Alcohol-related illnesses seemed to not confound the results of this study. Conclusions HE is significantly associated with an increased risk of osteoporotic hip fractures, and the significance is not affected by the comorbidities in people aged more than 50 years. The cumulative risk of fracture increases with age.

scholarly journals Sexual Dimorphism in Laryngeal Volumetric Measurements Using Magnetic Resonance Imaging

2019 ◽  
Vol 99 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Elie Khalifee ◽  
Georges Ziade ◽  
Sahar Semaan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Statistical Significance ◽  
Resonance Imaging ◽  
Men And Women ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
The Right ◽  
Volumetric Measurements

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.

scholarly journals Bisphosphonate Use and Hospitalization for Hip Fractures in Women: An Observational Population-Based Study in France

2021 ◽  
Vol 18 (16) ◽  
pp. 8780
Author(s):  
Bastien Bourrion ◽  
Cécile Souty ◽  
Lucie Fournier ◽  
Ana-Maria Vilcu ◽  
Thierry Blanchon ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Primary Outcome ◽  
Real Life ◽  
Osteoporotic Fractures ◽  
Population Based ◽  
Medication Persistence ◽  
Population Based Study ◽  
Osteoporotic Hip Fracture ◽  
Overall Effectiveness

Bisphosphonates are widely used in the treatment of women at risk of osteoporotic hip fracture; however, the overall effectiveness of bisphosphonates in the prevention of osteoporotic fractures has not been studied in real life. To investigate whether the use of bisphosphonates in women aged 50 years and over is associated with a decrease in hospitalization for osteoporotic hip fractures, a historical prospective cohort study was conducted between 2009 and 2016 from a permanent representative sample consisting of 1/97 of the French health insurance beneficiaries. Bisphosphonate use was defined according to medication persistence and adherence regarding bisphosphonate dispensations. The primary outcome was the hospitalization rate for osteoporotic hip fracture. Among the 81,268 women included, 2005 were exposed to bisphosphonates. The median time of bisphosphonate exposure was 12 (IQR, 3–29) and 17 (IQR, 5–42) months for the persistence and adherence definitions, respectively. Exposure to bisphosphonates was not associated with a decrease in hospitalization for hip fracture: weighted HRadherence = 0.66 (95% CI, 0.33 to 1.33); HRpersistance = 0.77 (95% CI, 0.38 to 1.57). In real life, bisphosphonate use does not appear to reduce hospitalization for hip fractures, as to date, it is probably prescribed as primary prevention and for a duration too short to be effective.

scholarly journals obesity paradox and mortality after pathological hip fractures: a Swedish registry study

2022 ◽  
pp. 185-189
Author(s):  
Jessica Ehne ◽  
Panagiotis Tsagozis ◽  
Anja Lind ◽  
Rikard Wedin ◽  
Margareta Hedström
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Patient Survival ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Obesity Paradox ◽  
Clinical Parameter ◽  
Overweight And Obesity ◽  
Study Cohort ◽  
Nutritional Studies

Background and purpose — Obesity as measured by BMI has been associated with increased survival in various diseases, a phenomenon known as the “obesity paradox.” It is unknown whether obesity is associated with survival after pathological fractures. We investigated the association between BMI and survival after surgery for pathological hip fracture, to improve survival prognostication, and lay grounds for further interventional nutritional studies. Patients and methods — We analyzed prospectively collected data from Swedish nationwide registry “RIKSHÖFT.” The study cohort included 1,000 patients operated for a pathological hip fracture between 2014 and 2019. BMI registered on admission was available in 449 patients. Overall patient survival was measured according to the Kaplan–Meier method. Multivariable regression was used to evaluate association with other potential factors that influence patient survival. Results — Overweight and obesity were associated with an increased postoperative survival in male patients with surgically treated pathological hip fractures. Multivariable analysis considering potential confounders confirmed this finding. The association was not that strong in women and did not reach statistical significance. Interpretation — BMI, a commonly available clinical parameter, is a good predictor of overall survival for patients operated on for pathological hip fracture. Incorporation of BMI in existent survival prognostication algorithms should be considered. Treatment of malnutrition in this frail group of patients is worth studying.

scholarly journals Incidence, morbidity and mortality of hip fractures over a period of 20 years in a health area of Southern Spain

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037101
Author(s):  
Marta M Rey-Rodriguez ◽  
MA Vazquez-Gamez ◽  
Mercè Giner ◽  
Fernando Garrachón-Vallo ◽  
Luis Fernández-López ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Incidence Rate ◽  
Hip Fractures ◽  
Age Groups ◽  
Factors Associated ◽  
Osteoporotic Hip Fracture ◽  
Health Area ◽  
Modifiable Factors ◽  
High Incidence ◽  
Degree Of Disability

ObjectiveTo evaluate the incidence of osteoporotic hip fracture in the Macarena Health Area (Seville).Setting and participantsThis was a prospective observational study that collected all osteoporotic hip fractures that occurred between March 2013 and February 2014 at the Clinical Unit of Traumatology and Orthopaedics. All cases collected during the first 6 months of the study were followed for 1 year after the occurrence of the event.Outcome measuresWe evaluated the incidence of osteoporotic hip fractures in the Macarena Health Area (Seville) from 1 March 2013 to 28 February 2014, and we compared the incidence with that in 2 previous studies carried out with the same methodology in 1994 and 2006. Furthermore, we calculated the morbidity and degree of disability 1 year after the fracture occurred and determined mortality and the associated factors.ResultsThe overall incidence was 228 per 100 000 individuals/year (95% CI 204.5 to 251.6), and the incidence was higher in women than in men. In women, the incidence rate decreased in all age groups over time, while in men, the incidence rate increased. The mortality rate 1 year after the episode was 27.2%. The factors associated with overall mortality were a body mass index below 25 kg/m2, renal failure and low plasma proteins.ConclusionsOur results show a high incidence of osteoporotic hip fracture that is increasing in men, and in men it is associated with a higher mortality than in women. There is room to improve the modifiable factors associated with mortality and the available rehabilitation interventions to reduce the disability associated with these fractures.

scholarly journals Utility of Geriatric Assessment in the Projection of Early Mortality Following Hip Fracture in the Elderly Patients

2018 ◽  
Vol 9 ◽  
pp. 215145931881397 ◽  
Author(s):  
Aunaly Palmer ◽  
Lisa A. Taitsman ◽  
May J. Reed ◽  
Bala G. Nair ◽  
Itay Bentov
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Demographic Data ◽  
Geriatric Medicine ◽  
The Elderly ◽  
Energy Mechanism ◽  
Intraoperative Hypotension ◽  
Short Term Mortality ◽  
The Mean ◽  
Poor Outcomes

Hip fractures result in significant morbidity and mortality in elders. Indicators of frailty are associated with poor outcomes. Commonly used frailty tools rely on motor skills that cannot be performed by this population. We determined the association between the Charlson Comorbidity Score (CCS), intraoperative hypotension (IOH), and a geriatric medicine consult index (GCI) with short-term mortality in hip fracture patients. A retrospective cohort study was conducted at a single institution over a 2-year period. Patients aged 65 years and older who sustained a hip fracture following a low-energy mechanism were identified using billing records and our orthopedic fracture registry. Medical records were reviewed to collect demographic data, fracture classification and operative records, calculation of CCS, intraoperative details including hypotension, and assessments recorded in the geriatric consult notes. The GCI was calculated using 30 dichotomous variables contained within the geriatric consult note. The index, ranging from 0 to 1, included markers for physical and cognitive function, as well as medications. A higher GCI score indicated more markers for frailty. One hundred eight patients met inclusion criteria. Sixty-four (59%) were females and the average age was 77.3 years. Thirty-five (32%) patients sustained femoral neck fractures, and 73 (68%) patients sustained inter-/pertrochanteric hip fractures. The 30-day mortality was 6%; the 90-day mortality was 13%. The mean GCI was 0.30 in the 30-day survivor group as compared to 0.52 in those who died. The mean GCI was 0.28 in patients who were alive at 90 days as compared to 0.46 in those who died. In contrast, the CCS and IOH were not associated with 30- or 90-day mortality. In our older hip fracture patients, an index calculated from information routinely obtained in the geriatric consult evaluation was associated with 30- and 90-day mortality, whereas the CCS and measures of IOH were not.

scholarly journals 07 Rehabilitation in Patients with Dementia Following Hip Fracture

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Cliona Small ◽  
Emma Lennon ◽  
Rebecca Low ◽  
Rachael Doyle ◽  
Shane O'Hanlon
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Admission Rate ◽  
Clinical Frailty Scale ◽  
Admission Rates ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
The Mean ◽  
One Year ◽  
Lost To Follow Up

Abstract Background Hip fractures are an increasing phenomenon in the older population. Receiving post-operative rehabilitation is associated with better outcomes and a higher likelihood of returning to preexisting level of functioning. Best rehabilitation practices for people with dementia have not been established. Methods All patients >/= 60 years old with a hip fracture admitted under the orthopaedic team between March 2016-February 2018 were reviewed. Those with a diagnosis of dementia were extracted from the database. Clinical Frailty Scale (CFS), Zuckermann Functional Recovery Score (FRS) and New Mobility Score (NMS) were documented at baseline and at one year. Outcomes assessed included 1 year mortality, decline FRS/NMS, change in CFS and nursing home (NH) admission rates. Results 465 patients’ hip fractures were recorded: 175 patients had dementia. 67 patients were dead at 1-year post fracture (38.285% mortality rate). Of the 108 patients with dementia who were living at 1-year; 30.5% (n=33) received offsite rehab. 58.4% (n=63) received routine in-patient rehab. 12 lost to follow-up. Of the 33 patients that received off-site rehab the mean FRS at baseline was 66 and decreased to 45.56 at 1 year (30.9% reduction). The mean CFS at baseline was 5.1, increasing to 6 at 1-year (17% increase). Mean NMS was 5.7 decreasing to 3.7 at 1-year. In those patients with dementia that did not receive off site rehab (n=63); baseline mean FRS was 38 reducing to 30 at 1 year (26.6 % reduction). Mean CFS was 6.25- increasing to 6.47 at 1 year. 41% of patients admitted from home who did not receive off-site rehab were discharged to NH. Of the group discharged to off-site rehab: at 1 year 33% were in a NH and 72% remained at home. Conclusion Both groups demonstrated decline in function. Those that received off-site rehab had higher premorbid functioning/mobility and reduced frailty. There was a reduced NH admission rate at 1-year in the group that received off-site rehab.

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