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Effect of comorbidities on the association between age and hospital mortality after fall-related hip fracture in elderly patients

Abstract

Summary

The relation between age and mortality after hip fracture was analyzed in elderly patients. 5.5% of the 31,884 patients died. Compared to those 65–74 years old, the multivariate OR for mortality for those 75–84 and ≥85 were 2.11 (95% CI: 1.61–2.77) and 4.10 (95% CI: 3.14–5.35).

Purpose

To analyze the impact of Elixhauser comorbidities on the relation between age and mortality after hip fracture in elderly patients.

Methods

Cross-sectional study of the population ≥65 years old hospitalized in Spain in 2013 with a diagnosis of fall-related hip fracture in the Basic Minimum Set Data (BMSD). The impact of Elixhauser comorbidities on the association between mortality and age groups (65–74, 75–84, ≥85) was analyzed by logistic regression models with progressive adjustment for demographic variables and comorbidities introduced individually.

Results

We identified 31,884 patients, 5.5% of which died during hospitalization. Compared with those 65–74 years old, the multivariate OR of mortality for those 75–84 and ≥85 years old decreased from 2.23 (95% CI: 1.71–2.90) and 4.57 (95% CI: 3.54–5.90) to 2.11 (95% CI: 1.61–2.77) and 4.10 (95% CI: 3.14–5.35), respectively after adjustment for comorbidities. The OR of mortality for men was 1.77 (95% CI: 1.58–1.98) compared to women. The comorbidities with higher OR for mortality were congestive heart failure (OR: 3.88; 95% CI: 3.42–4.41), metastasis (OR: 3.44; 95% CI: 2.27–5.20), fluid and electrolyte disorders (OR: 2.95; 95% CI: 2.47–3.52), coagulation deficiencies (OR: 2.87; 95% CI: 2.08–3.96), and liver disease (OR: 2.40; 95% CI: 1.82–3.17).

Conclusions

The association between age and mortality after hip fracture remains after adjusting for numerous comorbidities. However, some potentially controllable disorders are associated with an increased risk for mortality, thus, improving their management could benefit survival.

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Abbreviations

BMDS:

basic minimum data set

CI:

confidence interval

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Correspondence to A. Padrón-Monedero.

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Conflict of interest

Alicia Padrón-Monedero, Teresa López-Cuadrado, Iñaki Galán, Elena V. Martínez-Sánchez, Pilar Martin and Rafael Fernández-Cuenca declare that they have no conflict of interest.

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This study was approved by the Institutional Review Board of the Carlos III Institute of Health.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Padrón-Monedero, A., López-Cuadrado, T., Galán, I. et al. Effect of comorbidities on the association between age and hospital mortality after fall-related hip fracture in elderly patients. Osteoporos Int 28, 1559–1568 (2017). https://doi.org/10.1007/s00198-017-3926-2

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  • DOI: https://doi.org/10.1007/s00198-017-3926-2

Keywords

  • Comorbidities
  • Elderly
  • Falls
  • Mortality