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The mortality burde...
The mortality burden of frailty in hip fracture patients : a nationwide retrospective study of cause-specific mortality
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- Forssten, Maximilian Peter, 1996- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Mohammad Ismail, Ahmad, 1993- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery
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- Ioannidis, Ioannis, 1967- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Wretenberg, Per, 1963- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Borg, Tomas, 1963- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery
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- Cao, Yang, Associate Professor, 1972- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Ribeiro Jr, Marcelo A. F. (author)
- Pontifical Catholic University of São Paulo, São Paulo, Brazil; Trauma, Burns, Critical Care and Acute Care Surgery, Department of Surgery, Sheikh Shakhbout Medical City-Mayo Clinic, Abu Dhabi, United Arab Emirates
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- Mohseni, Shahin, 1978- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery
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(creator_code:org_t)
- 2022-12-26
- 2023
- English.
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In: European Journal of Trauma and Emergency Surgery. - : Springer. - 1863-9933 .- 1863-9941. ; 49:3, s. 1467-1475
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https://doi.org/10.1...
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Abstract
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- Purpose: Frailty is a condition characterized by a reduced ability to adapt to external stressors because of a reduced physiologic reserve, which contributes to the high risk of postoperative mortality in hip fracture patients. This study aims to investigate how frailty is associated with the specific causes of mortality in hip fracture patients.Methods: All adult patients in Sweden who suffered a traumatic hip fracture and underwent surgery between 2008 and 2017 were eligible for inclusion. The Orthopedic Hip Frailty Score (OFS) was used to classify patients as non-frail (OFS 0), pre-frail (OFS 1), and frail (OFS & GE; 2). The association between the degree of frailty and both all-cause and cause-specific mortality was determined using Poisson regression models with robust standard errors and presented using incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs), adjusted for potential sources of confounding.Results: After applying the inclusion and exclusion criteria, 127,305 patients remained for further analysis. 23.9% of patients were non-frail, 27.7% were pre-frail, and 48.3% were frail. Frail patients exhibited a 4 times as high risk of all-cause mortality 30 days [adj. IRR (95% CI): 3.80 (3.36-4.30), p < 0.001] and 90 days postoperatively [adj. IRR (95% CI): 3.88 (3.56-4.23), p < 0.001] as non-frail patients. Of the primary causes of 30-day mortality, frailty was associated with a tripling in the risk of cardiovascular [adj. IRR (95% CI): 3.24 (2.64-3.99), p < 0.001] and respiratory mortality [adj. IRR (95% CI): 2.60 (1.96-3.45), p < 0.001] as well as a five-fold increase in the risk of multiorgan failure [adj. IRR (95% CI): 4.99 (3.95-6.32), p < 0.001].Conclusion: Frailty is associated with a significantly increased risk of all-cause and cause-specific mortality at 30 and 90 days postoperatively. Across both timepoints, cardiovascular and respiratory events along with multiorgan failure were the most prevalent causes of mortality.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Frailty
- Hip fracture
- Postoperative mortality
- Cause-specific mortality
- Poisson regression
Publication and Content Type
- ref (subject category)
- art (subject category)
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Forssten, Maximi ...
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Mohammad Ismail, ...
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Ioannidis, Ioann ...
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Wretenberg, Per, ...
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Borg, Tomas, 196 ...
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Cao, Yang, Assoc ...
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Ribeiro Jr, Marc ...
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Mohseni, Shahin, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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European Journal ...
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Örebro University