The mortality burden in patients with hip fractures and dementiaShow others and affiliations
2022 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 48, no 4, p. 2919-2952Article in journal (Refereed) Published
Abstract [en]
PURPOSE: Dementia is strongly associated with postoperative death in patients subjected to hip fracture surgery. Nevertheless, there is a distinct lack of research investigating the cause of postoperative mortality in patients with dementia. This study aims to investigate the distribution and the risk of cause-specific postoperative mortality in patients with dementia compared to the general hip fracture population.
METHODS: All adults who underwent emergency hip fracture surgery in Sweden between 1/1/2008 and 31/12/2017 were considered for inclusion. Pathological, conservatively managed fractures, and reoperations were excluded. The database was retrieved by cross-referencing the Swedish National Quality Registry for Hip Fracture patients with the Swedish National Board of Health and Welfare quality registers. A Poisson regression model was used to determine the association between dementia and all-cause as well as cause-specific 30-day postoperative mortality.
RESULTS: 134,915 cases met the inclusion criteria, of which 20% had dementia at the time of surgery. The adjusted risk of all-cause 30-day postoperative mortality was 67% higher in patients with dementia after hip fracture surgery compared to patients without dementia [adj. IRR (95% CI): 1.67 (1.60-1.75), p < 0.001]. The risk of cause-specific mortality was also higher in patients with dementia, with up to a sevenfold increase in the risk cerebrovascular mortality [adj. IRR (95% CI): 7.43 (4.99-11.07), p < 0.001].
CONCLUSIONS: Hip fracture patients with dementia have a higher risk of death in the first 30 days postoperatively, with a substantially higher risk of mortality due to cardiovascular, respiratory, and cerebrovascular events, compared to patients without dementia.
Place, publisher, year, edition, pages
Urban und Vogel Medien und Medizin Verlagsgesellsc , 2022. Vol. 48, no 4, p. 2919-2952
Keywords [en]
Cause-specific mortality, Dementia, Hip fracture, Postoperative mortality
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-90032DOI: 10.1007/s00068-021-01612-4ISI: 000622707200001PubMedID: 33638650Scopus ID: 2-s2.0-85101857216OAI: oai:DiVA.org:oru-90032DiVA, id: diva2:1532021
Note
Funding Agency:
Örebro University
2021-03-012021-03-012024-03-06Bibliographically approved