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Dysphagia is associated with increased mortality risk after hip fracture surgery

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

This study aims to explore the prevalence of dysphagia, as well as mortality associated with dysphagia in the elderly population receiving surgical treatment for a hip fracture.

Methods

A retrospective cohort study was completed at an academic level 1 tertiary care center. Patients older than or equal to 65 admitted with a hip fracture diagnosis from January 2015 to December 2020 (n = 617) were included. The main outcome was the prevalence of dysphagia and association with mortality. Secondary analysis included timing of dysphagia and contributions to mortality.

Results

Fifty-six percent of patients had dysphagia, and the mortality rates were higher in patients with dysphagia (8.9%) versus those without dysphagia (2.6%), chi-square p = 0.001, and odds ratio 3.69 (CI 1.6–8.5). Mortality rates in patients with acute dysphagia were also higher (12.4%) than those with chronic dysphagia (5%) and chi-squared p = 0.02. Mortality rates in patients with a perioperative dysphagic event (13.9%) were higher than those with non-perioperative dysphagia (4%) and chi-squared p = 0.001. Mortality rates in patients who had acute perioperative dysphagia (21.2%) were higher than those with chronic dysphagia that presented perioperatively (6.8%) and chi-squared p = 0.006.

Conclusions

This study demonstrates high rates of dysphagia in the elderly hip fracture population and a significant association between dysphagia and mortality. Timing and chronicity of dysphagia were relevant, as patients with acute perioperative dysphagia had the highest mortality rate. Unlike other identified risk factors, dysphagia may be at least partially modifiable. More research is needed to determine whether formal evaluation and treatment of dysphagia lowers mortality risk.

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Funding

There was no funding for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Rd, Charlottesville, VA, USA

    Rohan M. Boyapati, Timothy M. Hoggard, Seth R. Yarboro & Michael M. Hadeed

Authors
  1. Rohan M. Boyapati
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  2. Timothy M. Hoggard
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  3. Seth R. Yarboro
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  4. Michael M. Hadeed
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Correspondence to Michael M. Hadeed.

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The authors have no relevant financial or non-financial interests to disclose.

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Institutional Review Board for Health Sciences Research (IRB-HSR) approval was obtained prior to starting the study. The study did not require informed consent.

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Boyapati, R.M., Hoggard, T.M., Yarboro, S.R. et al. Dysphagia is associated with increased mortality risk after hip fracture surgery. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03918-6

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  • DOI: https://doi.org/10.1007/s00590-024-03918-6

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