<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjph-2016-0015_s_367_w2aab3b8c10b1b7b1aab1c15b1Aa"><h3>Background</h3><p>There are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients.</p></sec><sec id="j_sjph-2016-0015_s_368_w2aab3b8c10b1b7b1aab1c15b2Aa"><h3>Methods</h3><p>The study included all patients with a hip fracture older than 65 who had been admitted to the Clinic for orthopaedic surgery during one year. One hundred and ninety-two patients were included in the study.</p></sec><sec id="j_sjph-2016-0015_s_370_w2aab3b8c10b1b7b1aab1c15b3Aa"><h3>Results</h3><p>Six months after admission due to a hip fracture, 48 patients had died (6-month mortality rate was 25%). The deceased were statistically older than the patients who had survived. Univariate regression analysis indicated that six variables had a significant effect on hip fracture patients’ survival: age, mobility prior to the fracture, poor cognitive status, activity of daily living, comorbidities and the place where they had fallen. Multivariate regression modelling showed that the following factors were independently associated with mortality at 6 months post fracture: poor cognitive status, poor mobility prior to the fracture, comorbid disease.</p></sec><sec id="j_sjph-2016-0015_s_371_w2aab3b8c10b1b7b1aab1c15b4Aa"><h3>Conclusion</h3><p>Poor cognitive status appeared to be the strongest mortality predictor. The employment of brief tests for cognitive status evaluation would enable orthopaedists to have good criteria for the choice of treatment for each patient screened.</p></sec></abstract>

BackgroundThere are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients.MethodsThe study included all patients with a hip fracture older than 65 who had been admitted to the Clinic for orthopaedic surgery during one year. One hundred and ninety-two patients were included in the study.ResultsSix months after admission due to a hip fracture, 48 patients had died (6-month mortality rate was 25%). The deceased were statistically older than the patients who had survived. Univariate regression analysis indicated that six variables had a significant effect on hip fracture patients’ survival: age, mobility prior to the fracture, poor cognitive status, activity of daily living, comorbidities and the place where they had fallen. Multivariate regression modelling showed that the following factors were independently associated with mortality at 6 months post fracture: poor cognitive status, poor mobility prior to the fracture, comorbid disease.ConclusionPoor cognitive status appeared to be the strongest mortality predictor. The employment of brief tests for cognitive status evaluation would enable orthopaedists to have good criteria for the choice of treatment for each patient screened.

Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture

University of Kragujevac, Faculty of Medical Sciences, Svetozara Markovica 69, 34000 Kragujevac,

Clinical Center Kragujevac, Zmaj Jovina 30, 34000 Kragujevac,

Centre for Clinical Pharmacology, Medical Faculty Military Medical Academy, University of Defence, Belgrade,

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

DEJAVNIKI, KI VPLIVAJO NA ŠESTMESEČNO STOPNJO UMRLJIVOSTI PRI BOLNIKIH Z ZLOMOM KOLKA

BackgroundThere are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor...

Variable	Crude OR (95% CI)	p	Adjusted OR (95% CI)	p
Age	0.88 (0.84-0.94)	<0.001 - significant difference (p<0.05)	0.95 (0.88-1.02)	0.153
Gender	1.10 (0.54-2.26)	0.786	-	-
SPMSQ (≤3)	15.40 (6.76-35.10)	<0.001 - significant difference (p<0.05)	4.88 (1.74-13.66)	0.003 - significant difference (p<0.05)
Ability to walk	5.36 (2.93-9.82)	<0.001 - significant difference (p<0.05)	2.73 (1.32-5.66)	0.007 - significant difference (p<0.05)
Place of the injury	3.27 (1.55-6.91)	0.002 - significant difference (p<0.05)	1.14 (0.43-3.02)	0.797
ADL	1.24 (1.12-1.37)	<0.001 - significant difference (p<0.05)	1.08 (0.93-1.24)	0.315
Comorbidities	0.34 (0.21-0.56)	<0.001 - significant difference (p<0.05)	0.51 (0.26-0.98)	0.043 - significant difference (p<0.05)

Variable	Deaths (n=48)	Surviving (n=144)	Statistically significant
Age	80.23±6.60	75.43±6.00	p<0.001
Gender
Male	14 (29.2%)	45 (31.3%)	p=0.786
Female	34 (70.8%)	99 (68.7%)	p=0.786
SPMSQ
≤3	28 (58.3%)	12 (8.3%)	p<0.001
≤3	20 (41.7%)	132 (91.7%)	p<0.001
Ability to walk
tied to bed	18 (37.5%)	4 (2.8%)	p<0.001
use of assistive devices	21 (43.7%	64 (44.4%)
without assistive devices	9 (18.8%)	76 (52.8%)
Place of the injury
in the home	37 (77.1%)	73 (50.7%)	p=0.0024
out of the home	11 (22.9%)	71 (49.3%)	p=0.0024
ADL	2.25±0.54	2.84±0.39	p<0.001
Comorbidities
mild diseases	15 (31.3%)	80 (55.5%)	p<0.001
moderate diseases	17 (35.4%)	56 (38.9%)
severe diseases	16 (33.3%)	8 (5.6%)

Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture

Article Category: Original scientific article

Published Online: Feb 11, 2016

Page range: 112 - 117

Received: Dec 09, 2014

Accepted: Nov 20, 2015

DOI: https://doi.org/10.1515/sjph-2016-0015

Keywords
cognitive status, comorbidity, poor cognitive status, hip fracture, six-month mortality

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The univariate and multivariate logistic regression with the outcome (deaths/ surviving) as the dependent variable.

Basic characteristics of the patients with hip fractures.

Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture

Article Category: Original scientific article

Published Online: Feb 11, 2016

Page range: 112 - 117

Received: Dec 09, 2014

Accepted: Nov 20, 2015

DOI: https://doi.org/10.1515/sjph-2016-0015

Keywordscognitive status, comorbidity, poor cognitive status, hip fracture, six-month mortality

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The univariate and multivariate logistic regression with the outcome (deaths/ surviving) as the dependent variable.

Basic characteristics of the patients with hip fractures.

Keywords
cognitive status, comorbidity, poor cognitive status, hip fracture, six-month mortality