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Journal of Trauma Management & Outcomes

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Open Access 01-12-2012 | Research

Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences

Authors: Alexander A Fisher, Wichat Srikusalanukul, Michael W Davis, Paul N Smith

Published in: Journal of Trauma Management & Outcomes | Issue 1/2012

Abstract

Background

Data on clinical characteristics and outcomes in regard to hip fracture (HF) type are controversial. This study aimed to evaluate whether clinical and laboratory predictors of poorer outcomes differ by HF type.

Methods

Prospective evaluation of 761 consecutively admitted patients (mean age 82.3 ± 8.8 years; 74.9% women) with low-trauma non-pathological HF. Clinical characteristics and short-term outcomes were recorded. Haematological, renal, liver and thyroid status, C-reactive protein, cardiac troponin I, serum 25(OH) vitamin D, PTH, leptin, adiponectin and resistin were determined.

Results

The cervical compared to the tronchanteric HF group was younger, have higher mean haemoglobin, albumin, adiponectin and resistin and lower PTH levels (all P < 0.05). In-hospital mortality, length of hospital stay (LOS), incidence of post-operative myocardial injury and need of institutionalisation were similar in both groups. Multivariate analysis revealed as independent predictors for in-hospital death in patient with cervical HF male sex, hyperparathyroidism and lower leptin levels, while in patients with trochanteric HF only hyperparathyroidism; for post-operative myocardial injury dementia, smoking and renal impairment in the former group and coronary artery disease (CAD), hyperparathyroidism and hypoleptinaemia in the latter; for LOS > 20 days CAD, and age > 75 years and hyperparathyroidism, respectively. Need of institutionalisation was predicted by age > 75 years and dementia in both groups and also by hypovitaminosis D in the cervical and by hyperparathyroidism in the trochanteric HF.

Conclusions

Clinical characteristics and incidence of poorer short-term outcomes in the two main HF types are rather similar but risk factors for certain outcomes are site-specific reflecting differences in underlying mechanisms.

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Title: Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences
Authors: Alexander A Fisher
Wichat Srikusalanukul
Michael W Davis
Paul N Smith
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Journal of Trauma Management & Outcomes / Issue 1/2012
Electronic ISSN: 1752-2897
DOI: https://doi.org/10.1186/1752-2897-6-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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