Prediction of Mortality in Hip Fracture Patients:Role of Routine Blood Tests

Document Type : RESEARCH PAPER

Authors

1 Kashan University of Medical Sciences, Kashan, Iran

2 Trauma Research Center, Kashan University of Medical Sciences, Kashan, I.R. Iran

3 Trauma research Center, Kashan University of medical Sciences, Kashan, Iran

4 Kashan University of medical Sciences, Kashan, Iran

5 Student Research Committee, Arak University of Medical Sciences, Arak, Iran

6 Trauma research Center, Kashan University of Medical Sciences, Kashan, Iran

Abstract

 Methods:
In a retrospective descriptive study, medical records of 204 hip fractured patients with the age of 60 or older who were admitted to the Department of Orthopedics was considered regarding routine laboratory tests. Predictive values of these tests were assessed using receiver operating characteristic curve (ROC).
 Results:
The incidence of death due to hip fracture was 24%. The mortality rate was significantly increased with age > 65 (OR= 15). There was no significant difference between mortality in regards to gender. High plasma BUN (more than 20 mg/dl) and creatinine (more than 1.3 mg/dl) significantly increased the chance of mortality. [OR= 3.0 and OR=2.5 for BUN and creatinine, respectively]. Patients’ mortality did not show any correlation with sodium and potassium plasma levels and blood hemoglobin.
Conclusions:
There is direct correlation between plasma levels of BUN and creatinine and 3-month mortality after hip fractures. Patients with high plasma levels of BUN were three times more likely to die than those with normal BUN. Also, patients with high plasma creatinine levels were 2.5 times more likely to die than those who had normal values. Mortality was also associated with increasing age but did not vary with gender. Patients aging more than 65 were 15 times more likely to die following a hip fracture than those with younger age.

Keywords

References

  1. Laulund AS, Lauritzen JB, Duus BR, Mosfeldt M, Jørgensen HL. Routine blood tests as predictors of mortality in hip fracture patients. Injury. 2012; 43(7):1014-20.
  2. National Hospital Discharge Survey (NHDS), National Center for Health Statistics. Available at: http://205.207.175.93/hdi/ReportFolders/ReportFolders.aspx?IF_ActivePath=P,18.  Accessed August 29, 2013.
  3. Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT. Effect of birth cohort on risk of hip fracture: age-specific incidence rates in the Framingham Study. Am J Public Health. 2002;92(5):858-62.
  4. Scott JC. Osteoporosis and hip fractures. Rheum Dis Clin North Am. 1990; 16(3):717-40.
  5. Nguyen ND, Eisman JA, Center JR, Nguyen TV. Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab. 2007;92:955–62.
  6. Greenspan WL, Myers ER, Maitland LA, Kido TH, Krasnow MB, Hayes WC. Trochanteric bone mineral density is associate with type of hip fracture in the elderly. J Bone Miner Res. 1994;9(12):1889-94.
  7. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006; 17:1726–33.
  8. Ahmadi-Abhari S, Moayyeri A, Abolhassani F. Burden of hip fracture in Iran. Calcif Tissue Int. 2007; 80(3):147-53.
  9. Wehren LE, Magaziner J. Hip fracture: risk factors and outcomes. Curr Osteoporos Rep. 2003;1:78-85.
  10. Rosell PA, Parker MJ. Functional outcome after hip fracture. A 1-year prospective outcome study of 275 patients. Injury. 2003;34:529-32.
  11. Pedersen SJ, Borgbjerg FM, Schousboe B, Pedersen BD, Jørgensen HL, Duus BR, et al. A comprehensive hip fracture program reduces complication rates and mortality. J Am Geriatr Soc. 2008; 56:1831-8.
  12. Jiang HX, Majumdar SR, Dick DA, Moreau M, Raso J, Otto DD, et al. Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patients with hip fractures. J Bone Miner Res. 2005; 20:494-500.
  13. Moran CG, Wenn RT, Sikand M, Taylor AM. Early mortality after hip fracture: Is delay before surgery important? J Bone Joint Surg Am. 2005; 87:483-9.
  14. Farahmand BY, Michaëlsson K, Ahlbom A, Ljunghall S, Baron JA; Swedish Hip Fracture Study Group. Survival after hip fracture. Osteoporos Int. 2005;16:1583-90.
  15. Giversen IM. Time trends of mortality after first hip fractures. Osteoporos Int. 2007; 18(6):721-32.
  16. Bredah C, Nyholm B, Hindsholm KB,  Mortensen JS, Olesen AS. Mortality after hip fracture: results of operation within 12 h of admission. Injury. 1992; 23:83-6
  17. Pioli G, Barone A, Giusti A, Oliveri M, Pizzonia M, Razzano M, Palummeri E. Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res. 2006; 18(5):381-7.
  18. Bhaskar D, Parker MJ. Haematological indices as surrogate markers of factors affecting mortality after hip fracture. Injury. 2011; 42(2):178-82.
  19. Ho CA, Li CY, Hsieh KS, Chen HF. Factors determining the 1-year survival after operated hip fracture: a hospital-based analysis. J Orthop Sci. 2010; 15(1):30-7.
  20. Mosfeldt M, Pedersen OB, Riis T, Worm HO, Mark Sv, Jørgensen HL,et al. Value of routine blood tests for prediction of mortality risk in hip fracture patients. Acta Orthop. 2012; 83(1):31-5.
  21. Petersen MB1, Jørgensen HL, Hansen K, Duus BR. Factors affecting postoperative mortality of patients with displaced femoral neck fracture. Injury. 2006; 37(8):705-11.
  22. Frost SA, Nguyen ND, Black DA, Eisman JA, Nguyen TV. Risk factors for in-hospital post-hip fracture mortality. Bone. 2011; 49(3):553-8.
  23. Oztürk A, Ozkan Y, Akgöz S, Yalçýn N, Ozdemir RM, Aykut S. The risk factors for mortality in elderly patients with hip fractures: postoperative one-year results. Singapore Med J. 2010; 51(2):137-43.
  24. Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, et al. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010; 152(6):380-90.
  25. Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL. The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil. 2010; 1(1):6-14.
  26. Zolfaghari M, Taghizadeh Z, Maghbouli J, Keshtkar AA, Kazemnejad A, Larijani B, et al. The incidence of osteoporotic hip fracture in 3 years fallow up of Iranian Multicenters Osteoporosis Study (IMOS). J Reprod Infertil. 2005;6(1):37-42.
  27. A place for Mam. Hip Fracture in the Elderly and Assisted Care. Available at: http://www.aplaceformom.com/senior-care-resources/articles/hip-fractures-in-the-elderly. Accessed May 29, 2014.
The Archives of Bone and Joint Surgery
Volume 3, Issue 1 - Serial Number 1
January 2015
Pages 51-55

Files

History

  • Receive Date: 01 October 2014
  • Revise Date: 27 November 2014
  • Accept Date: 07 December 2014

Share

How to cite

Statistics