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Predictive factors for thirty day mortality in geriatric patients with hip fractures: a prospective study

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Abstract

Purpose

The study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors.

Methods

A prospective multicentric study was performed. All patients aged ≥ 65 years, with fragility hip fractures, consecutively admitted in two Italian hospitals were included. Patients with periprosthetic or pathological fractures were excluded. Logistic regression was used to identify patient and patient care variables that independently influenced the 30-day mortality and receiver operating characteristic (ROC) curve analysis to assess their predictive capacity on the outcome.

Results

Of the patients, 728 met the inclusion criteria, of whom approximately 5% died within 30 days after admission. The 45.7% of the deceased patients died while hospitalized. Multivariate analysis showed that advancing age was the only independent predictor of 30-day mortality (OR = 1.084, 95% CI = 1.024–1.147), while a higher presence of informal caregivers was a protective factor (OR = 0.988, 95% CI = 0.979–0.997). The area under the ROC curve of the model was 0.723 (CI95% 0.676–0.770) for 30-day mortality in elderly hip fractures patients.

Conclusions

Patients with an advanced age need careful follow-up, especially within 30 days following operation for hip fracture; at the same time, the presence of informal caregivers at the patient’s bedside should be promoted.

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Acknowledgements

The authors would like to thank all individuals who participated in this study and Dr. Elettra Pignotti, expert in Biostatistics, for her contribution by performing statistical analysis.

Author information

Authors and Affiliations

  1. Rizzoli Orthopedic Institute, Via Pupilli 1, 40136, Bologna, Italy

    Cristiana Forni, Fabio D’Alessandro, Ambra Fiorani, Mattia Morri & Tania Sabattini

  2. Centro Studi EBN, Azienda Ospedaliero-Universitaria, Via Albertoni 15, 40138, Bologna, Italy

    Domenica Gazineo

  3. Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy

    Elisa Ambrosi & Paolo Chiari

Authors
  1. Cristiana Forni
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  2. Domenica Gazineo
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  3. Fabio D’Alessandro
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  4. Ambra Fiorani
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  5. Mattia Morri
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  6. Tania Sabattini
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  7. Elisa Ambrosi
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  8. Paolo Chiari
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Contributions

CF, PC: concept and design, acquisition of subjects and data, analysis and interpretation of data, preparation of manuscript. DG, EA: analysis and interpretation of data, preparation of manuscript. FD, AF, MM, TS: acquisition of subjects and data, analysis and interpretation of data, preparation of manuscript.

Corresponding author

Correspondence to Elisa Ambrosi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Forni, C., Gazineo, D., D’Alessandro, F. et al. Predictive factors for thirty day mortality in geriatric patients with hip fractures: a prospective study. International Orthopaedics (SICOT) 43, 275–281 (2019). https://doi.org/10.1007/s00264-018-4057-x

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  • DOI: https://doi.org/10.1007/s00264-018-4057-x

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