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The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil
Background Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding r...
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| Published in: | Clinical orthopaedics and related research 2010-07, Vol.468 (7), p.1869-1883 |
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| container_title | Clinical orthopaedics and related research |
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| creator | Pereira, Silvia R. M. Puts, Martine T. E. Portela, Margareth C. Sayeg, Mario A. |
| description | Background
Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America.
Questions/Purpose
We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area.
Methods
Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture.
Results
Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk.
Conclusions
Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil.
Level of Evidence
Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence. |
| doi_str_mv | 10.1007/s11999-009-1147-5 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2881997</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733248960</sourcerecordid><originalsourceid>FETCH-LOGICAL-c564t-6d93413c8f2fa645a35c98b9422ea251a47a228fbb4c61a363e1da7f97ac71d03</originalsourceid><addsrcrecordid>eNp1kV1rFDEUhoModq3-AG8kCOLVaD4nyY1QF2sLlfaignfhTCbTTZlN1mRGqL_eDLu2KniVk3Oe8_ki9JKSd5QQ9b5QaoxpCDENpUI18hFaUcl0_XH2GK3IEjGMfjtCz0q5rV8uJHuKjmoab3VLV6i73nh8vt2Bm3Aa8FX2Q672nD2G2OOzsMOnvx3rDSymz6FMwRWcIv6S8gRjmO5wiPhy7H3GVz6XFMvi-JjhZxifoycDjMW_OLzH6Ovpp-v1WXNx-fl8fXLRONmKqWl7wwXlTg9sgFZI4NIZ3RnBmAcmKQgFjOmh64RrKfCWe9qDGowCp2hP-DH6sK-7m7ut752PU4bR7nLYQr6zCYL9OxLDxt6kH5ZpXQ-iaoG3hwI5fZ99mew2FOfHEaJPc7GKcya0aZdWr_8hb9OcY93OKkGJIlosEN1DLqdS6mHvR6HELvrZvX62qmQX_aysOa_-3OEh4yBYBd4cACgOxipWdKHcc4wZJYUQlWN7rtRQvPH5YcL_d_8FGlKzbA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>741070840</pqid></control><display><type>article</type><title>The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil</title><source>PubMed (Medline)</source><creator>Pereira, Silvia R. M. ; Puts, Martine T. E. ; Portela, Margareth C. ; Sayeg, Mario A.</creator><creatorcontrib>Pereira, Silvia R. M. ; Puts, Martine T. E. ; Portela, Margareth C. ; Sayeg, Mario A.</creatorcontrib><description>Background
Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America.
Questions/Purpose
We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area.
Methods
Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture.
Results
Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk.
Conclusions
Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil.
Level of Evidence
Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-009-1147-5</identifier><identifier>PMID: 19936861</identifier><identifier>CODEN: CORTBR</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Accidental Falls ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Brazil - epidemiology ; Cause of Death ; Clinical Research ; Comorbidity ; Conservative Orthopedics ; Diseases of the osteoarticular system ; Female ; Health Status ; Hip Fractures - mortality ; Hospitals, Municipal ; Humans ; Injuries of the limb. Injuries of the spine ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteoporosis - mortality ; Postoperative Complications ; Predictive Value of Tests ; Proportional Hazards Models ; Prospective Studies ; Recovery of Function ; Risk Factors ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Survival Rate ; Traumas. Diseases due to physical agents</subject><ispartof>Clinical orthopaedics and related research, 2010-07, Vol.468 (7), p.1869-1883</ispartof><rights>The Association of Bone and Joint Surgeons® 2009</rights><rights>2015 INIST-CNRS</rights><rights>The Association of Bone and Joint Surgeons® 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-6d93413c8f2fa645a35c98b9422ea251a47a228fbb4c61a363e1da7f97ac71d03</citedby><cites>FETCH-LOGICAL-c564t-6d93413c8f2fa645a35c98b9422ea251a47a228fbb4c61a363e1da7f97ac71d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881997/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881997/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22975444$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19936861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pereira, Silvia R. M.</creatorcontrib><creatorcontrib>Puts, Martine T. E.</creatorcontrib><creatorcontrib>Portela, Margareth C.</creatorcontrib><creatorcontrib>Sayeg, Mario A.</creatorcontrib><title>The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America.
Questions/Purpose
We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area.
Methods
Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture.
Results
Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk.
Conclusions
Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil.
Level of Evidence
Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.</description><subject>Accidental Falls</subject><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Brazil - epidemiology</subject><subject>Cause of Death</subject><subject>Clinical Research</subject><subject>Comorbidity</subject><subject>Conservative Orthopedics</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Health Status</subject><subject>Hip Fractures - mortality</subject><subject>Hospitals, Municipal</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteoporosis - mortality</subject><subject>Postoperative Complications</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Risk Factors</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Survival Rate</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNp1kV1rFDEUhoModq3-AG8kCOLVaD4nyY1QF2sLlfaignfhTCbTTZlN1mRGqL_eDLu2KniVk3Oe8_ki9JKSd5QQ9b5QaoxpCDENpUI18hFaUcl0_XH2GK3IEjGMfjtCz0q5rV8uJHuKjmoab3VLV6i73nh8vt2Bm3Aa8FX2Q672nD2G2OOzsMOnvx3rDSymz6FMwRWcIv6S8gRjmO5wiPhy7H3GVz6XFMvi-JjhZxifoycDjMW_OLzH6Ovpp-v1WXNx-fl8fXLRONmKqWl7wwXlTg9sgFZI4NIZ3RnBmAcmKQgFjOmh64RrKfCWe9qDGowCp2hP-DH6sK-7m7ut752PU4bR7nLYQr6zCYL9OxLDxt6kH5ZpXQ-iaoG3hwI5fZ99mew2FOfHEaJPc7GKcya0aZdWr_8hb9OcY93OKkGJIlosEN1DLqdS6mHvR6HELvrZvX62qmQX_aysOa_-3OEh4yBYBd4cACgOxipWdKHcc4wZJYUQlWN7rtRQvPH5YcL_d_8FGlKzbA</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Pereira, Silvia R. M.</creator><creator>Puts, Martine T. E.</creator><creator>Portela, Margareth C.</creator><creator>Sayeg, Mario A.</creator><general>Springer-Verlag</general><general>Springer</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100701</creationdate><title>The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil</title><author>Pereira, Silvia R. M. ; Puts, Martine T. E. ; Portela, Margareth C. ; Sayeg, Mario A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-6d93413c8f2fa645a35c98b9422ea251a47a228fbb4c61a363e1da7f97ac71d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Accidental Falls</topic><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Brazil - epidemiology</topic><topic>Cause of Death</topic><topic>Clinical Research</topic><topic>Comorbidity</topic><topic>Conservative Orthopedics</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Health Status</topic><topic>Hip Fractures - mortality</topic><topic>Hospitals, Municipal</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteoporosis - mortality</topic><topic>Postoperative Complications</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Risk Factors</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Survival Rate</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pereira, Silvia R. M.</creatorcontrib><creatorcontrib>Puts, Martine T. E.</creatorcontrib><creatorcontrib>Portela, Margareth C.</creatorcontrib><creatorcontrib>Sayeg, Mario A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pereira, Silvia R. M.</au><au>Puts, Martine T. E.</au><au>Portela, Margareth C.</au><au>Sayeg, Mario A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>468</volume><issue>7</issue><spage>1869</spage><epage>1883</epage><pages>1869-1883</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><coden>CORTBR</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Background
Hip fractures in the elderly are common and associated with considerable mortality and disability. Although well known in industrialized countries, the factors associated with mortality after hip fractures are not reported frequently in developing countries and little is known regarding risk factors in Latin America.
Questions/Purpose
We investigated the rate of 1-year mortality and prefracture and fracture characteristics associated with mortality after a hip fracture in elderly Brazilian patients in a large metropolitan area.
Methods
Two hundred forty-six persons 60 years and older admitted to four hospitals in Rio de Janeiro were included after experiencing fractures and were followed for 1 year. Data were collected on sociodemographic, health, and functional status; type of surgery; length of stay; and complications after surgery. Cox regression analyses were conducted to investigate factors associated with 1-year mortality after hip fracture.
Results
Of the 246 patients, 86 died (35%). Of those 86, 22 died in the hospital (25.6%) and 64 (74.4%) died after discharge. Functional status before fracture, older age, male gender, and higher surgical risk increased the risk of mortality, whereas the use of antibiotics and the use of physical therapy after surgery decreased the risk.
Conclusions
Our mortality rate was higher than those reported from industrialized countries. The use of antibiotics and physical therapy are potentially modifiable factors to improve patients’ survival after fracture in Brazil.
Level of Evidence
Level II, prognostic study. See the Guidelines for Authors for a complete description of the levels of evidence.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19936861</pmid><doi>10.1007/s11999-009-1147-5</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical orthopaedics and related research, 2010-07, Vol.468 (7), p.1869-1883 |
| issn | 0009-921X 1528-1132 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2881997 |
| source | PubMed (Medline) |
| subjects | Accidental Falls Activities of Daily Living Aged Aged, 80 and over Biological and medical sciences Brazil - epidemiology Cause of Death Clinical Research Comorbidity Conservative Orthopedics Diseases of the osteoarticular system Female Health Status Hip Fractures - mortality Hospitals, Municipal Humans Injuries of the limb. Injuries of the spine Male Medical sciences Medicine Medicine & Public Health Middle Aged Orthopedics Osteoporosis - mortality Postoperative Complications Predictive Value of Tests Proportional Hazards Models Prospective Studies Recovery of Function Risk Factors Sports Medicine Surgery Surgical Orthopedics Survival Rate Traumas. Diseases due to physical agents |
| title | The Impact of Prefracture and Hip Fracture Characteristics on Mortality in Older Persons in Brazil |
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