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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 4/2021

01-08-2021 | Original Article

Thyroid-stimulating hormone (TSH) is associated with 30-day mortality in hip fracture patients

Authors: Etienne Rapacki, Jes B. Lauritzen, Christian M. Madsen, Henrik L. Jørgensen, Debbie Norring-Agerskov

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2021

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Abstract

Purpose

The aim of this study is to assess the possible association between thyroid-stimulating hormone (TSH) and mortality in hip fracture patients.

Patients and methods

The study is based on a hip fracture database from Bispebjerg University Hospital (Copenhagen, Denmark). This database includes all hip fracture patients (ICD-10 codes DS720 (femoral neck), DS721 (pertrochanteric), and DS722 (subtrochanteric)) admitted to Bispebjerg Hospital from 1996 to 2012. From this database, we identified all surgically treated hip fracture patients aged > 60 years with available plasma TSH-measurements at admission.

Results

Of the 914 included patients (24% men and 76% women), 10.5% died within 30 days. At inclusion, 161 (17.6%) of the patients were hyperthyroid (TSH < 0.65 mIU/L), 58 (6.4%) were hypothyroid (TSH > 4.8 mIU/L), while 695 (76.0%) were euthyroid (0.65 < TSH < 4.80 mIU/L), p = 0.03. Mortality was significantly higher in the two higher quartiles of TSH [Q3 (13.0%) and Q4 (15.4%)] compared to the two lower quartiles [Q1 (7.4%) and Q2 (6.2%), p = 0.0003. After adjustment for age, sex and Charlson Comorbidity Index (CCI) in a Cox proportional hazard model, the risk of 30-day mortality continued to be increased in patients with TSH above the median as compared to patients with TSH below the median (HR 2.1 (1.4–3.3), p = 0.0006].

Conclusion

The study demonstrates increased 30-day mortality in surgically treated hip fracture patients with plasma TSH levels above the median (1.41 mIU/L) at admission, even after adjusting for age, sex and CCI.
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Metadata
Title
Thyroid-stimulating hormone (TSH) is associated with 30-day mortality in hip fracture patients
Authors
Etienne Rapacki
Jes B. Lauritzen
Christian M. Madsen
Henrik L. Jørgensen
Debbie Norring-Agerskov
Publication date
01-08-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01260-9

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