Factors determining the 1-year survival after operated hip fracture

A hospital-based analysis

Ching An Ho, Chung-Yi Li, Kou Shiong Hsieh, Hua Fen Chen

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Factors associated with 1-year survival of hip fracture in Chinese ethnicities has not been clearly elucidated. The purpose of this study was to determine the 1-year survival associated with operated hip fracture and its prognostic factors in a district teaching hospital from January 1, 1998 to 2006. Methods: Hip fracture admissions (ICD-9: 820) identified from an inpatient electronic database over a 9-year period were linked to Taiwan's national death registry. Actuarial analysis was used to determine the 1-year survival rates after hip fracture, which were further compared according to different concurrent illnesses. We used the Cox proportional hazard regression model to explore the significant determinants of 1-year survival of the study patients. Results: The overall 1-year survival rate of all patients was 86%. This was lower if the operation was accompanied by certain co-morbidities, including heart failure [hazard ratio (HR) 6.12; 95% confidence interval (CI) 1.54-24.36], chronic obstructive pulmonary disease (HR 2.40; 95% CI 1.14-5.05), and pneumonia (HR 4.26; 95% CI 1.95-9.31). In addition, elderly patients (>84 years of age) (HR 7.34; 95% CI 2.49-21.58), arthroplasty (HR 3.69; 95% CI 1.10-12.43), operative delay >48 h (HR 2.86; 95% CI 1.08-7.54), low preoperative hemoglobin level (<11 g/dl) (HR 2.58; 95% CI 1.33-5.01), and high creatinine level (≥2 mg/dl) (HR 2.52; 95% CI 1.07-5.95) were all significantly associated with increased mortality. Conclusions: The 1-year survival for patients in this study hospital, 86%, was comparable to or higher than that of previous studies. Improved survival rates among hip fracture patients may be achieved by early recognition and prompt treatment of associated medical illnesses.

Original languageEnglish
Pages (from-to)30-37
Number of pages8
JournalJournal of Orthopaedic Science
Volume15
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

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Hip Fractures
Confidence Intervals
Survival
Survival Rate
Actuarial Analysis
District Hospitals
International Classification of Diseases
Taiwan
Proportional Hazards Models
Teaching Hospitals
Arthroplasty
Chronic Obstructive Pulmonary Disease
Registries
Inpatients
Creatinine
Pneumonia
Hemoglobins
Heart Failure
Databases
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Factors determining the 1-year survival after operated hip fracture: A hospital-based analysis",
abstract = "Background: Factors associated with 1-year survival of hip fracture in Chinese ethnicities has not been clearly elucidated. The purpose of this study was to determine the 1-year survival associated with operated hip fracture and its prognostic factors in a district teaching hospital from January 1, 1998 to 2006. Methods: Hip fracture admissions (ICD-9: 820) identified from an inpatient electronic database over a 9-year period were linked to Taiwan's national death registry. Actuarial analysis was used to determine the 1-year survival rates after hip fracture, which were further compared according to different concurrent illnesses. We used the Cox proportional hazard regression model to explore the significant determinants of 1-year survival of the study patients. Results: The overall 1-year survival rate of all patients was 86{\%}. This was lower if the operation was accompanied by certain co-morbidities, including heart failure [hazard ratio (HR) 6.12; 95{\%} confidence interval (CI) 1.54-24.36], chronic obstructive pulmonary disease (HR 2.40; 95{\%} CI 1.14-5.05), and pneumonia (HR 4.26; 95{\%} CI 1.95-9.31). In addition, elderly patients (>84 years of age) (HR 7.34; 95{\%} CI 2.49-21.58), arthroplasty (HR 3.69; 95{\%} CI 1.10-12.43), operative delay >48 h (HR 2.86; 95{\%} CI 1.08-7.54), low preoperative hemoglobin level (<11 g/dl) (HR 2.58; 95{\%} CI 1.33-5.01), and high creatinine level (≥2 mg/dl) (HR 2.52; 95{\%} CI 1.07-5.95) were all significantly associated with increased mortality. Conclusions: The 1-year survival for patients in this study hospital, 86{\%}, was comparable to or higher than that of previous studies. Improved survival rates among hip fracture patients may be achieved by early recognition and prompt treatment of associated medical illnesses.",
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Factors determining the 1-year survival after operated hip fracture : A hospital-based analysis. / Ho, Ching An; Li, Chung-Yi; Hsieh, Kou Shiong; Chen, Hua Fen.

In: Journal of Orthopaedic Science, Vol. 15, No. 1, 01.01.2010, p. 30-37.

Research output: Contribution to journalArticle

TY - JOUR

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N2 - Background: Factors associated with 1-year survival of hip fracture in Chinese ethnicities has not been clearly elucidated. The purpose of this study was to determine the 1-year survival associated with operated hip fracture and its prognostic factors in a district teaching hospital from January 1, 1998 to 2006. Methods: Hip fracture admissions (ICD-9: 820) identified from an inpatient electronic database over a 9-year period were linked to Taiwan's national death registry. Actuarial analysis was used to determine the 1-year survival rates after hip fracture, which were further compared according to different concurrent illnesses. We used the Cox proportional hazard regression model to explore the significant determinants of 1-year survival of the study patients. Results: The overall 1-year survival rate of all patients was 86%. This was lower if the operation was accompanied by certain co-morbidities, including heart failure [hazard ratio (HR) 6.12; 95% confidence interval (CI) 1.54-24.36], chronic obstructive pulmonary disease (HR 2.40; 95% CI 1.14-5.05), and pneumonia (HR 4.26; 95% CI 1.95-9.31). In addition, elderly patients (>84 years of age) (HR 7.34; 95% CI 2.49-21.58), arthroplasty (HR 3.69; 95% CI 1.10-12.43), operative delay >48 h (HR 2.86; 95% CI 1.08-7.54), low preoperative hemoglobin level (<11 g/dl) (HR 2.58; 95% CI 1.33-5.01), and high creatinine level (≥2 mg/dl) (HR 2.52; 95% CI 1.07-5.95) were all significantly associated with increased mortality. Conclusions: The 1-year survival for patients in this study hospital, 86%, was comparable to or higher than that of previous studies. Improved survival rates among hip fracture patients may be achieved by early recognition and prompt treatment of associated medical illnesses.

AB - Background: Factors associated with 1-year survival of hip fracture in Chinese ethnicities has not been clearly elucidated. The purpose of this study was to determine the 1-year survival associated with operated hip fracture and its prognostic factors in a district teaching hospital from January 1, 1998 to 2006. Methods: Hip fracture admissions (ICD-9: 820) identified from an inpatient electronic database over a 9-year period were linked to Taiwan's national death registry. Actuarial analysis was used to determine the 1-year survival rates after hip fracture, which were further compared according to different concurrent illnesses. We used the Cox proportional hazard regression model to explore the significant determinants of 1-year survival of the study patients. Results: The overall 1-year survival rate of all patients was 86%. This was lower if the operation was accompanied by certain co-morbidities, including heart failure [hazard ratio (HR) 6.12; 95% confidence interval (CI) 1.54-24.36], chronic obstructive pulmonary disease (HR 2.40; 95% CI 1.14-5.05), and pneumonia (HR 4.26; 95% CI 1.95-9.31). In addition, elderly patients (>84 years of age) (HR 7.34; 95% CI 2.49-21.58), arthroplasty (HR 3.69; 95% CI 1.10-12.43), operative delay >48 h (HR 2.86; 95% CI 1.08-7.54), low preoperative hemoglobin level (<11 g/dl) (HR 2.58; 95% CI 1.33-5.01), and high creatinine level (≥2 mg/dl) (HR 2.52; 95% CI 1.07-5.95) were all significantly associated with increased mortality. Conclusions: The 1-year survival for patients in this study hospital, 86%, was comparable to or higher than that of previous studies. Improved survival rates among hip fracture patients may be achieved by early recognition and prompt treatment of associated medical illnesses.

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