Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Journal of Orthopaedic Surgery & Traumatology

08-04-2024 | Dysphagia | Original Article

Dysphagia is associated with increased mortality risk after hip fracture surgery

Authors: Rohan M. Boyapati, Timothy M. Hoggard, Seth R. Yarboro, Michael M. Hadeed

Published in: European Journal of Orthopaedic Surgery & Traumatology

Login to get access

Abstract

Purpose

This study aims to explore the prevalence of dysphagia, as well as mortality associated with dysphagia in the elderly population receiving surgical treatment for a hip fracture.

Methods

A retrospective cohort study was completed at an academic level 1 tertiary care center. Patients older than or equal to 65 admitted with a hip fracture diagnosis from January 2015 to December 2020 (n = 617) were included. The main outcome was the prevalence of dysphagia and association with mortality. Secondary analysis included timing of dysphagia and contributions to mortality.

Results

Fifty-six percent of patients had dysphagia, and the mortality rates were higher in patients with dysphagia (8.9%) versus those without dysphagia (2.6%), chi-square p = 0.001, and odds ratio 3.69 (CI 1.6–8.5). Mortality rates in patients with acute dysphagia were also higher (12.4%) than those with chronic dysphagia (5%) and chi-squared p = 0.02. Mortality rates in patients with a perioperative dysphagic event (13.9%) were higher than those with non-perioperative dysphagia (4%) and chi-squared p = 0.001. Mortality rates in patients who had acute perioperative dysphagia (21.2%) were higher than those with chronic dysphagia that presented perioperatively (6.8%) and chi-squared p = 0.006.

Conclusions

This study demonstrates high rates of dysphagia in the elderly hip fracture population and a significant association between dysphagia and mortality. Timing and chronicity of dysphagia were relevant, as patients with acute perioperative dysphagia had the highest mortality rate. Unlike other identified risk factors, dysphagia may be at least partially modifiable. More research is needed to determine whether formal evaluation and treatment of dysphagia lowers mortality risk.
Literature
1.
2.
Kazley J, Bagchi K (2023) Femoral neck fractures. StatPearls. StatPearls Publishing
3.
Michael Lewiecki E et al (2018) Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 29:717–722CrossRefPubMed
4.
Swenning T, Leighton J, Nentwig M, Dart B (2020) Hip fracture care and national systems: The United States and Canada. OTA Int Open Access J Orthop Trauma 3:e073
5.
Roberts SE, Goldacre MJ (2003) Time trends and demography of mortality after fractured neck of femur in an English population, 1968–98: database study. BMJ 327:771–775CrossRefPubMedPubMedCentral
6.
7.
8.
Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL (2010) The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil 1:6–14CrossRefPubMedPubMedCentral
9.
Karres J, Kieviet N, Eerenberg J-P, Vrouenraets BC (2018) predicting early mortality after hip fracture surgery: the hip fracture estimator of mortality Amsterdam. J Orthop Trauma 32:27–33CrossRefPubMed
10.
Madsen G et al (2020) Prevalence of swallowing and eating difficulties in an elderly postoperative hip fracture population-a multi-center-based pilot study. Geriatr Basel Switz 5:52CrossRef
11.
Love AL, Cornwell PL, Whitehouse SL (2013) Oropharyngeal dysphagia in an elderly post-operative hip fracture population: a prospective cohort study. Age Ageing 42:782–785CrossRefPubMed
12.
13.
Namasivayam AM, Steele CM (2015) Malnutrition and dysphagia in long-term care: a systematic review. J Nutr Gerontol Geriatr 34:1–21CrossRefPubMed
14.
Meals C et al (2016) Identifying the risk of swallowing-related pulmonary complications in older patients with hip fracture. Orthopedics 39:e93-97CrossRefPubMed
15.
Byun S-E, Kwon KB, Kim SH, Lim S-J (2019) The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea. BMC Geriatr 19:356CrossRefPubMedPubMedCentral
16.
Allen J, Greene M, Sabido I, Stretton M, Miles A (2020) Economic costs of dysphagia among hospitalized patients. Laryngoscope 130:974–979CrossRefPubMed
17.
Hu F, Jiang C, Shen J, Tang P, Wang Y (2012) Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury 43:676–685CrossRefPubMed
18.
Sue Eisenstadt E (2010) Dysphagia and aspiration pneumonia in older adults. J Am Acad Nurse Pract 22:17–22CrossRefPubMed
19.
20.
21.
22.
Miller N (2013) Oropharyngeal dysphagia in an elderly post-operative hip fracture population. Age Ageing 42:679–681CrossRefPubMed
23.
Mateos-Nozal J, Sanchez Garcia E, Romero Rodríguez E, Cruz-Jentoft AJ (2021) Oropharyngeal dysphagia in older patients with hip fracture. Age Ageing 50:1416–1421CrossRefPubMed
Metadata
Title
Dysphagia is associated with increased mortality risk after hip fracture surgery
Authors
Rohan M. Boyapati
Timothy M. Hoggard
Seth R. Yarboro
Michael M. Hadeed
Publication date
08-04-2024
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-024-03918-6