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Thyroid-stimulating hormone (TSH) is associated with 30-day mortality in hip fracture patients

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to assess the possible association between thyroid-stimulating hormone (TSH) and mortality in hip fracture patients.

Patients and methods

The study is based on a hip fracture database from Bispebjerg University Hospital (Copenhagen, Denmark). This database includes all hip fracture patients (ICD-10 codes DS720 (femoral neck), DS721 (pertrochanteric), and DS722 (subtrochanteric)) admitted to Bispebjerg Hospital from 1996 to 2012. From this database, we identified all surgically treated hip fracture patients aged > 60 years with available plasma TSH-measurements at admission.

Results

Of the 914 included patients (24% men and 76% women), 10.5% died within 30 days. At inclusion, 161 (17.6%) of the patients were hyperthyroid (TSH < 0.65 mIU/L), 58 (6.4%) were hypothyroid (TSH > 4.8 mIU/L), while 695 (76.0%) were euthyroid (0.65 < TSH < 4.80 mIU/L), p = 0.03. Mortality was significantly higher in the two higher quartiles of TSH [Q3 (13.0%) and Q4 (15.4%)] compared to the two lower quartiles [Q1 (7.4%) and Q2 (6.2%), p = 0.0003. After adjustment for age, sex and Charlson Comorbidity Index (CCI) in a Cox proportional hazard model, the risk of 30-day mortality continued to be increased in patients with TSH above the median as compared to patients with TSH below the median (HR 2.1 (1.4–3.3), p = 0.0006].

Conclusion

The study demonstrates increased 30-day mortality in surgically treated hip fracture patients with plasma TSH levels above the median (1.41 mIU/L) at admission, even after adjusting for age, sex and CCI.

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Author information

Authors and Affiliations

  1. Department of Clinical Biochemistry, Hvidovre Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark

    Etienne Rapacki, Henrik L. Jørgensen & Debbie Norring-Agerskov

  2. Department of Orthopaedic Surgery, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    Jes B. Lauritzen

  3. Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark

    Jes B. Lauritzen, Christian M. Madsen & Henrik L. Jørgensen

  4. Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark

    Christian M. Madsen

  5. Odense Patient Data Explorative Network, University of Southern Denmark, Odense, Denmark

    Debbie Norring-Agerskov

  6. Odense University Hospital, J.B. Winsloews Vej, 5000, Odense, Denmark

    Debbie Norring-Agerskov

Authors
  1. Etienne Rapacki
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  2. Jes B. Lauritzen
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  3. Christian M. Madsen
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  4. Henrik L. Jørgensen
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  5. Debbie Norring-Agerskov
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Corresponding author

Correspondence to Henrik L. Jørgensen.

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Conflict of interest

Etienne Rapacki, Jes B. Lauritzen, Christian M. Madsen, Henrik L. Jørgensen and Debbie Norring-Agerskov declare that they have no conflict of interest.

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Rapacki, E., Lauritzen, J.B., Madsen, C.M. et al. Thyroid-stimulating hormone (TSH) is associated with 30-day mortality in hip fracture patients. Eur J Trauma Emerg Surg 47, 1081–1087 (2021). https://doi.org/10.1007/s00068-019-01260-9

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  • DOI: https://doi.org/10.1007/s00068-019-01260-9

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