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The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil

  • Clinical Research
  • Hip
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America.

Questions/Purpose

We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area.

Methods

Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture.

Results

Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk.

Conclusions

Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil.

Level of Evidence

Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.

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Acknowledgments

We thank Rebecca Rupp for careful editing of the article. The design of the study and data collection were performed at the Federal University of Rio De Janeiro and the data analyses and preparation of the manuscript were performed at the Oswaldo Cruz Foundation and at the Solidage Research Group on Frailty and Aging, Montreal, Canada, when Dr. Pereira was a visiting fellow 2007–2008.

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Author notes

  1. Martine T. E. Puts PhD

    Present address: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada

Authors and Affiliations

  1. Academic Hospital São Francisco de Assis, Federal University of Rio de Janeiro, Rua Gilberto Cardoso 260/703–Leblon, Rio de Janeiro, RJ, 22430-070, Brazil

    Silvia R. M. Pereira MD, PhD

  2. Solidage Research Group, Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, McGill University, Montreal, Canada

    Martine T. E. Puts PhD

  3. Department of Health Management and Planning, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

    Margareth C. Portela PhD & Mario A. Sayeg MD, PhD

Authors
  1. Silvia R. M. Pereira MD, PhD
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  2. Martine T. E. Puts PhD
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  3. Margareth C. Portela PhD
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  4. Mario A. Sayeg MD, PhD
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Corresponding author

Correspondence to Silvia R. M. Pereira MD, PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Mario A. Sayeg—Deceased.

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Pereira, S.R.M., Puts, M.T.E., Portela, M.C. et al. The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil. Clin Orthop Relat Res 468, 1869–1883 (2010). https://doi.org/10.1007/s11999-009-1147-5

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