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Risk factors for mortality in elderly patients with hip fractures: a meta-analysis of 18 studies

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

Hip fracture is common and associated with poor outcomes in elderly patients. This meta-analysis aims to investigate the risk factors that might increase the mortality rate in elderly patients with hip fracture.

Methods

PubMed, Embase, and Web of Science were systematically searched for observational studies regarding the prognostic factors of mortality in elderly patients with hip fracture. A fixed-effects or random-effects model was used to calculate pooled hazard ratio (HR) and 95% confidence intervals (95% CIs).

Results

Eighteen cohort studies, involving 223,875 patients, were included in this meta-analysis. The most prominent factors associated with mortality were higher age (HR 1.51, 95% CI 1.37, 1.67; P < 0.001), male gender (HR 1.91, 95% CI 1.67, 2.19; P < 0.001), cognitive impairment (HR 2.06, 95% CI 1.25, 3.40; P = 0.005), delirium (HR 2.14, 95% CI 1.50, 3.05; P < 0.001), dementia (HR 2.72, 95% CI 1.41, 5.26; P = 0.003), depression (HR 1.71, 95% CI 1.43, 2.05; P < 0.001), living with caregiver (HR 1.61, 95% CI 1.43, 1.82; P < 0.001), cardiovascular disease (HR 2.10, 95% CI 1.14, 3.86; P = 0.018), renal disease (HR 1.66, 95% CI 1.52, 1.82; P < 0.001), and malignancy (HR 1.75, 95% CI 1.30, 2.37; P = 0.031), whereas respiratory disease (HR 1.49, 95% CI 0.99, 2.24; P = 0.056), diabetes (HR 1.15, 95% CI 0.96, 1.37; P = 0.121), and smoking (HR 1.54, 95% CI 0.64, 3.71; P = 0.337) did not increase the risk of mortality.

Conclusion

The current study investigated several factors that might increase the risk of mortality in elderly patients with hip fracture. Further studies are needed to evaluate the effectiveness of specific interventions to reduce the risk of mortality.

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Authors and Affiliations

  1. Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China

    Yan Liu, Zhiqian Wang & Wenliang Xiao

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  1. Yan Liu
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  2. Zhiqian Wang
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  3. Wenliang Xiao
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Corresponding author

Correspondence to Zhiqian Wang.

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Conflict of interest

All the authors declare that they have no conflict of interest.

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Ethical statement

The study complies with ethical standards.

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For this type of study formal consent is not required.

Electronic supplementary material

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Eligibility of studies for inclusion in meta-analysis (TIF 751 KB)

Forest plot showing the relationship between age and mortality in elderly patients with hip fracture (TIF 1260 KB)

Forest plot showing the relationship between gender and mortality in elderly patients with hip fracture (TIF 1309 KB)

40520_2017_789_MOESM4_ESM.tif

Forest plot showing the relationship between cognitive impairment and mortality in elderly patients with hip fracture (TIF 1474 KB)

40520_2017_789_MOESM5_ESM.tif

Forest plot showing the relationship between psychiatric illness and mortality in elderly patients with hip fracture (TIF 1163 KB)

40520_2017_789_MOESM6_ESM.tif

Forest plot showing the relationship between living with caregiver and mortality in elderly patients with hip fracture (TIF 1459 KB)

40520_2017_789_MOESM7_ESM.tif

Forest plot showing the relationship between comorbidities and mortality in elderly patients with hip fracture (TIF 1190 KB)

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Liu, Y., Wang, Z. & Xiao, W. Risk factors for mortality in elderly patients with hip fractures: a meta-analysis of 18 studies. Aging Clin Exp Res 30, 323–330 (2018). https://doi.org/10.1007/s40520-017-0789-5

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  • DOI: https://doi.org/10.1007/s40520-017-0789-5

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