Summary

The mortality of elderly hip fracture patients is high. Eighty-five percent of all patients were followed until death. The three most protective factors for 1-year survival were ASA class; BMI; and age, and the four most protective factors for 14-year survival were age; BMI; ASA class; and subtrochanteric fracture type.

Objective

Hip fractures are associated with increased mortality. The purpose of this study was to evaluate the protective preoperative factors regarding the survival of short-term (1 year) and long-term (14 years) follow-up in a hip fracture cohort in Finland.

Methods

A total of 486 patients, operated on in 2005 and 2006, were retrospectively evaluated. Survival was analyzed using Bayesian multivariate analysis and relative survival with the life table method. All patients were followed for a minimum of 14 years.

Results

We analyzed 330 women and 156 men, whose mean ages were 82.4 and 72.0 years, respectively. The overall mortality rate was 7% at 1 month, 22% at 12 months, and 87% at 14 years. Protective factors against mortality at 1 year were ASA class (1–3), BMI ≥ 20 kg/m², age < 85 years, alcohol involvement, Alzheimer’s disease, no comorbidities, certain operative methods, and female sex. Factors promoting survival at 14 years were age < 75 years, BMI ≥ 20 kg/m², ASA class (1–2), subtrochanteric fracture, certain operative methods, alcohol involvement, and no comorbidities.

Conclusions

Protective factors for 1-year survival in order of importance were ASA class, BMI, and age, and, correspondingly, for 14-year survival, age, certain operative methods, BMI, and ASA class. The relative survival of hip fracture patients was lower than that of the general population.

中文翻译：

---

影响髋部骨折后生存的患者特异性因素——一项在芬兰进行的为期 14 年的随访研究

概括

老年髋部骨折患者的死亡率很高。所有患者中有 85% 得到随访直至死亡。1 年生存率的三个最具保护性的因素是 ASA 等级；体重指数；和年龄，14 年生存率的四个最重要的保护因素是年龄；体重指数；ASA类；和粗隆下骨折类型。

客观的

髋部骨折与死亡率增加有关。本研究的目的是评估影响芬兰髋部骨折队列短期（1 年）和长期（14 年）随访生存的保护性术前因素。

方法

对 2005 年和 2006 年接受手术的 486 名患者进行了回顾性评估。使用贝叶斯多变量分析和使用生命表方法的相对生存分析生存。所有患者的随访时间至少为 14 年。

结果

我们分析了 330 名女性和 156 名男性，他们的平均年龄分别为 82.4 岁和 72.0 岁。总死亡率在 1 个月时为 7%，在 12 个月时为 22%，在 14 年时为 87%。1 年死亡率的保护因素是 ASA 等级 (1–3)、BMI ≥ 20 kg/m ²、年龄 < 85 岁、酗酒、阿尔茨海默病、无合并症、某些手术方法和女性。促进 14 岁生存的因素是年龄 < 75 岁、BMI ≥ 20 kg/m ²、ASA 分级 (1-2)、转子下骨折、某些手术方法、酒精参与和无合并症。

结论

1 年生存的保护因素按重要性依次为 ASA 等级、BMI 和年龄，相应地，14 年生存的保护因素为年龄、某些手术方法、BMI 和 ASA 等级。髋部骨折患者的相对生存率低于一般人群。