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Differences in age-related characteristics among elderly patients with hip fractures
Journal of Orthopaedic Science ( IF 1.7 ) Pub Date : 2022-09-22 , DOI: 10.1016/j.jos.2022.08.009
Kenji Shigemoto 1 , Takeshi Sawaguchi 2 , Toshihiro Higashikawa 3 , Masashi Okuro 4
Affiliation  

Background

Incidence of hip fracture among aging patients has been increasing annually in Japan; patients aged ≤74 years may be inappropriately classified as elderly. This study aimed to identify differences in the incidence of serious perioperative complications and in-hospital, 90-day, 6-month, and 1-year mortality rates according to three age groups among patients with hip fractures.

Methods

Patients aged ≥65 years treated for hip fracture by our multidisciplinary treatment system were included in this study. They were divided into the pre-old age (65–74 years), old age (75–89 years), and super-old age (≥90 years) groups. The baseline characteristics and outcomes of the three groups were compared, and variables associated with in-hospital, 30-day, 6-month, and 1-year mortality were analyzed.

Results

In the older population, there was a higher proportion of female participants; those with trochanteric fractures, low bone mineral density, dementia, decreased walking ability and independence in performing activities of daily living; and those not living at home. Moreover, the proportion of patients with hypertension, diabetes mellitus, and circulatory disorders, American Society of Anesthesiologists Physical Status scores, and serum albumin levels significantly differed. Further, there was a significant difference in the incidence of serious complications among males and the 6-month and 1-year mortality rates among females. In addition, female patients in the pre-old age group had a higher mortality rate at any period compared with those in the old age group.

Conclusions

Patients with hip fracture who were aged 65–74, 75–89, and ≥90 years differ in terms of baseline characteristics, incidence of complications, and mortality rates. Female patients aged<75 who had fragility hip fractures potentially had worse prognosis. Our findings may be useful in preoperative explanation, postoperative management, and prognostic prediction.



中文翻译:

老年髋部骨折患者年龄相关特征的差异

背景

在日本,老年患者髋部骨折的发病率逐年增加;年龄≤74岁的患者可能被不恰当地归类为老年人。本研究旨在确定髋部骨折患者不同年龄组的严重围手术期并发症发生率以及院内死亡率、90 天死亡率、6 个月死亡率和 1 年死亡率的差异。

方法

本研究纳入了接受我们的多学科治疗系统治疗的年龄≥65岁的髋部骨折患者。将他们分为低龄组(65-74岁)、老年组(75-89岁)和超老年组(≥90岁)。比较三组的基线特征和结果,并分析与院内死亡率、30 天死亡率、6 个月死亡率和 1 年死亡率相关的变量。

结果

在老年人口中,女性参与者的比例较高;患有转子骨折、骨密度低、痴呆、行走能力和日常生活活动独立性下降的人;以及那些不住在家里的人。此外,患有高血压、糖尿病和循环系统疾病的患者比例、美国麻醉医师协会身体状况评分和血清白蛋白水平也存在显着差异。此外,男性严重并发症的发生率以及女性6个月和1年死亡率存在显着差异。此外,老年前期女性患者在任何时期的死亡率均高于老年组。

结论

65-74岁、75-89岁和≥90岁的髋部骨折患者在基线特征、并发症发生率和死亡率方面存在差异。年龄<75岁的脆性髋部骨折女性患者的预后可能较差。我们的研究结果可能有助于术前解释、术后管理和预后预测。

更新日期:2022-09-22
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