PurposeThe study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors.MethodsA prospective multicentric study was performed. All patients aged 65years, 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.ResultsOf the patients, 728 met the inclusion criteria, of whom approximately 5% died within 30days 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.ConclusionsPatients with an advanced age need careful follow-up, especially within 30days following operation for hip fracture; at the same time, the presence of informal caregivers at the patient's bedside should be promoted.

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

Ambrosi, Elisa;Chiari, Paolo
2019-01-01

Abstract

PurposeThe study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors.MethodsA prospective multicentric study was performed. All patients aged 65years, 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.ResultsOf the patients, 728 met the inclusion criteria, of whom approximately 5% died within 30days 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.ConclusionsPatients with an advanced age need careful follow-up, especially within 30days following operation for hip fracture; at the same time, the presence of informal caregivers at the patient's bedside should be promoted.
2019
30-day mortality; Geriatrics; Hip fractures; Prospective studies; Risk factors; Aged, 80 and over; Female; Humans; Incidence; Logistic Models; Male; Prospective Studies; ROC Curve; Risk Factors; Hip Fractures
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1006725
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