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Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study

BACKGROUND: Increasing longevity has caused the very old population to become the fastest-growing segment. The number of centenarians (over 100 years old) is increasing rapidly. Fractures in the elderly lead to excessive medical costs and decreased quality of life with socioeconomic burdens. However...

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Autores principales: Jang, Byung-Woong, Kim, Jin-Woo, Nho, Jae-Hwi, Lee, Young-Kyun, Park, Jung-Wee, Cha, Yong-Han, Kim, Ki-Choul, Yoo, Jun-Il, Kim, Jung-Taek, Koo, Kyung-Hoi, Suh, You-Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689221/
https://www.ncbi.nlm.nih.gov/pubmed/38045583
http://dx.doi.org/10.4055/cios23223
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author Jang, Byung-Woong
Kim, Jin-Woo
Nho, Jae-Hwi
Lee, Young-Kyun
Park, Jung-Wee
Cha, Yong-Han
Kim, Ki-Choul
Yoo, Jun-Il
Kim, Jung-Taek
Koo, Kyung-Hoi
Suh, You-Sung
author_facet Jang, Byung-Woong
Kim, Jin-Woo
Nho, Jae-Hwi
Lee, Young-Kyun
Park, Jung-Wee
Cha, Yong-Han
Kim, Ki-Choul
Yoo, Jun-Il
Kim, Jung-Taek
Koo, Kyung-Hoi
Suh, You-Sung
author_sort Jang, Byung-Woong
collection PubMed
description BACKGROUND: Increasing longevity has caused the very old population to become the fastest-growing segment. The number of centenarians (over 100 years old) is increasing rapidly. Fractures in the elderly lead to excessive medical costs and decreased quality of life with socioeconomic burdens. However, little research has thoroughly examined the functional outcomes and mortality of hip fractures in centenarians. METHODS: This is a retrospective observational study. Sixty-eight centenarian hip fracture patients were admitted to the 10 institutions from February 2004 to December 2019. Fifty-six patients with 1-year follow-up were finally included. The following data were obtained: sex, age, body mass index, Charlson comorbidity index value on the operation day, Koval’s classification for ambulatory ability, type of fracture, the time interval from trauma to surgery, American Society of Anesthesiologists grade, surgery-related complications, and duration of hospital stay. Postoperative Koval’s classification (at 1 year after surgery) and information about death were also collected. Multivariate analysis was performed to analyze the risk factors affecting mortality 1 year after surgery. RESULTS: Mortality rates were 26.8% at 6 months and 39.3% at 1 year. The 90-day mortality was 19.6%, and one of them (2.1%) died in the hospital. The 1-year mortality rates for the community ambulatory and non-community ambulatory groups were 29% and 52%, respectively. Only 9 (16.1%) were able to walk outdoors 1 year after surgery. The remaining 47 patients (83.9%) had to stay indoors after surgery. Multivariate analysis demonstrated that the pre-injury ambulatory level (adjusted hazard ratio, 2.884; p = 0.034) was associated with the risk of mortality. CONCLUSIONS: We report a 1-year mortality rate of 39.3% in centenarian patients with hip fractures. The risk factor for mortality was the pre-injury ambulatory status. This could be an important consideration in the planning of treatment for centenarian hip fracture patients.
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spelling pubmed-106892212023-12-02 Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study Jang, Byung-Woong Kim, Jin-Woo Nho, Jae-Hwi Lee, Young-Kyun Park, Jung-Wee Cha, Yong-Han Kim, Ki-Choul Yoo, Jun-Il Kim, Jung-Taek Koo, Kyung-Hoi Suh, You-Sung Clin Orthop Surg Original Article BACKGROUND: Increasing longevity has caused the very old population to become the fastest-growing segment. The number of centenarians (over 100 years old) is increasing rapidly. Fractures in the elderly lead to excessive medical costs and decreased quality of life with socioeconomic burdens. However, little research has thoroughly examined the functional outcomes and mortality of hip fractures in centenarians. METHODS: This is a retrospective observational study. Sixty-eight centenarian hip fracture patients were admitted to the 10 institutions from February 2004 to December 2019. Fifty-six patients with 1-year follow-up were finally included. The following data were obtained: sex, age, body mass index, Charlson comorbidity index value on the operation day, Koval’s classification for ambulatory ability, type of fracture, the time interval from trauma to surgery, American Society of Anesthesiologists grade, surgery-related complications, and duration of hospital stay. Postoperative Koval’s classification (at 1 year after surgery) and information about death were also collected. Multivariate analysis was performed to analyze the risk factors affecting mortality 1 year after surgery. RESULTS: Mortality rates were 26.8% at 6 months and 39.3% at 1 year. The 90-day mortality was 19.6%, and one of them (2.1%) died in the hospital. The 1-year mortality rates for the community ambulatory and non-community ambulatory groups were 29% and 52%, respectively. Only 9 (16.1%) were able to walk outdoors 1 year after surgery. The remaining 47 patients (83.9%) had to stay indoors after surgery. Multivariate analysis demonstrated that the pre-injury ambulatory level (adjusted hazard ratio, 2.884; p = 0.034) was associated with the risk of mortality. CONCLUSIONS: We report a 1-year mortality rate of 39.3% in centenarian patients with hip fractures. The risk factor for mortality was the pre-injury ambulatory status. This could be an important consideration in the planning of treatment for centenarian hip fracture patients. The Korean Orthopaedic Association 2023-12 2023-10-20 /pmc/articles/PMC10689221/ /pubmed/38045583 http://dx.doi.org/10.4055/cios23223 Text en Copyright © 2023 by The Korean Orthopaedic Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jang, Byung-Woong
Kim, Jin-Woo
Nho, Jae-Hwi
Lee, Young-Kyun
Park, Jung-Wee
Cha, Yong-Han
Kim, Ki-Choul
Yoo, Jun-Il
Kim, Jung-Taek
Koo, Kyung-Hoi
Suh, You-Sung
Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title_full Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title_fullStr Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title_full_unstemmed Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title_short Hip Fractures in Centenarians: Functional Outcomes, Mortality, and Risk Factors from a Multicenter Cohort Study
title_sort hip fractures in centenarians: functional outcomes, mortality, and risk factors from a multicenter cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689221/
https://www.ncbi.nlm.nih.gov/pubmed/38045583
http://dx.doi.org/10.4055/cios23223
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