Maria Dolors Rosinés, Mercè Castejón, Joan Espaulella-Panicot, Anna Arnau
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引用次数: 0
Abstract
Fragility hip fractures significantly impact long-term survival in patients over 65 years. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. Advanced age, male sex, and cognitive/functional impairment increased mortality. Comprehensive assessments are essential for personalized treatment.
Purpose: Fragility hip fractures are increasing due to population aging. The main objective of this study was to determine long-term survival and the probability of dying from hip fracture or from other causes in patients over 65 years old who underwent surgery for a fragility hip fracture.
Methods: A retrospective cohort study was conducted between June 2010 and December 2021. The main outcomes were overall survival, relative survival, and the probability of dying either from hip fracture or from other causes at 1, 5, and 10 years after surgery determined with the WebSurvCa application.
Results: A total of 2646 patients were included with a median age of 86.3 years [81.7-90.3]; 75% were women. Overall survival was 76.0% (95% CI 74.4-77.7), 37.7% (95% CI 35.6-39.9), and 11.9% (95% CI 9.6-14.8) at 1, 5, and 10 years. The cumulative probability of dying from a hip fracture was 17.2%, 35.4%, and 49.4% at 1, 5, and 10 years, respectively. Factors such as advanced age, male sex, and prior functional or cognitive deterioration were associated with worse long-term survival. In patients over 85 years old, without functional dependence or with normal cognitive status, the probability of dying from other causes at 5 and 10 years exceeded that of dying from the hip fracture.
Conclusion: Our results highlight that long-term mortality in these patients is high, persisting even 10 years after the fracture. Comprehensive evaluation considering age, functional, and cognitive status is essential in order to predict outcomes and personalize treatment strategies.
脆性髋部骨折显著影响65岁以上患者的长期生存。1年、5年和10年的总生存率分别为76.0% （95% CI 74.4-77.7）、37.7% （95% CI 35.6-39.9）和11.9% （95% CI 9.6-14.8）。高龄、男性和认知/功能障碍增加了死亡率。全面评估对于个性化治疗至关重要。目的：由于人口老龄化，脆性髋部骨折越来越多。本研究的主要目的是确定65岁以上因脆性髋部骨折接受手术的患者的长期生存率和死于髋部骨折或其他原因的概率。方法：2010年6月至2021年12月进行回顾性队列研究。主要结果是总生存率、相对生存率以及术后1年、5年和10年因髋部骨折或其他原因死亡的概率，这些结果由WebSurvCa应用程序确定。结果：共纳入2646例患者，中位年龄86.3岁[81.7-90.3]；75%是女性。1年、5年和10年的总生存率分别为76.0% （95% CI 74.4-77.7）、37.7% （95% CI 35.6-39.9）和11.9% （95% CI 9.6-14.8）。在1年、5年和10年期间，髋部骨折死亡的累积概率分别为17.2%、35.4%和49.4%。高龄、男性、既往功能或认知退化等因素与较差的长期生存率相关。在85岁以上、无功能依赖或认知状态正常的患者中，5岁和10岁时其他原因死亡的概率大于髋部骨折死亡的概率。结论：我们的研究结果强调，这些患者的长期死亡率很高，甚至在骨折后10年仍持续存在。综合评估考虑年龄，功能和认知状态是必不可少的，以预测结果和个性化的治疗策略。
期刊介绍：
Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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