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Hip fracture among elderly people: a single cohort study from Kurdistan of Iraq



Abstract

Background: Hip fracture is considered a major health problem worldwide. The current study aimed to investigate hip fracture characteristics among older people in Iraq and factors involving postoperative mortality.

Method: A single cohort study was carried out in Sulaimani and Shar Teaching hospitals in Sulaimani from the 1st of July 2018 to 30th of June 2019.  Hip fracture was diagnosed by a specialist physician using an X-Ray. The data was collected by the researcher through direct interviews and filling a prepared uniform questionnaire. The data analyzed by SPSS and p-value<0.05 was significant.

Results: From the total of 100 hip fracture patients included, the average age of patients was 74.45±8.18 years. Fifty-nine patients aged 60 to 75 years, while the rest were older than 75 years. Female consisted of 59.0% of the total samples. Non-mechanical falls accounted for (84%) of all falls. Most patients had intertrochanteric fractures (65%), while 35% had femoral neck fractures. The Proximal femoral nail (PFN) operation was the primary type of operation (77%) performed. Most patients (94%) were discharged after two days. There was a significant association between gender and postoperative mortality; female patients had worse prognosis and higher mortality, relative risk (95%CI) 0.18 (0.0424 to 0.7788). Older patients aged 75 and more had a remarkably poorer prognosis than younger patients, relative risk (95%CI) 0.30 (0.10 to 0.93). There was a strong relationship between poor cognitive function (moderate to severe depression) and postoperative mortality rate with relative risk (95%CI) 0.04 (0.006 to 0.36). Finally, patients on three or more medications also had an outstanding worse prognosis, relative risk (95%CI) 0.022 (0.001 to 0.37).

Conclusion: Hip fracture was more common among women and people aged above 75 years. The prevalence of intertrochanteric fractures was nearly double the femoral neck fractures. Age, female, depression, and polypharmacy had a statistically significant association with three-month mortality in hip fracture patients.

Keywords: hip fracture elderly geriatric depression scale (GDS)

References

  1. Kalache A, Keller I. The greying world: a challenge for the twenty-first century. Sci Prog. 2000;83 ( Pt 1):33-54. PubMed PMID: 10800373.
  2. Hoidrup S, Sorensen TI, Gronbaek M, Schroll M. Incidence and characteristics of falls leading to hospital treatment. J Scand Public Health. 2003;31:24–30.
  3. Tinetti ME, Speechley M.. Prevention of falls among the elderly. J Ne Engl Med. 1989;320:1055-9.
  4. Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ. 2006 the 9th of March; 332(7541):571–4.
  5. Johnell O, Gullberg B, Allander E, Kanis JA. The apparent incidence of hip fracture in Europe: A study of national register sources. MEDOS Study Group. Osteoporos Int. 1992;2:298–302. [PubMed]
  6. Dinesh K Dhanwal, Elaine M Dennison, Nick C Harvey, and Cyrus Cooper. Epidemiology of hip fracture: Worldwide geographic variation. Indian Journal of Orthopaedics, 2011, 45(1): 15–22.
  7. Iglesias SL, Gentile Vanoli et al , femoral neck fracture in the elderly: from risk factors to prognostic feature for survival; Trauma Critical Care 2017;1(1):16-21.
  8. Mossey JA et al, determines of recovery 12 months after hip fracture: The importance of psychological factors. American Journal of Public Health. 1989;(79):3.
  9. Hershkovit A et al, Factors Affecting Short Term Rehabilitation Outcome of Disabled Elderly Patients with Proximal Hip Fracture. The American Congress of Rehabilitation. 2007;(7):916-920.
  10. Maalouf G, Bachour F, Hlais S, Maalouf NM, Yazbeck P, Yaghi Y, et al. Epidemiology of hip fractures in Lebanon: A nationwide survey. Orthop Traumatol Surg Res. 2013 the 1st of October;99(6):675–80.
  11. Yoo J-I, Lee Y-K, Koo K-H, Park Y-J, Ha Y-C. Concerns for Older Adult Patients with Acute Hip Fracture. Yonsei Med J. 2018 the 1st of December;59(10):1240–4.
  12. Zullo AR, Sorial MN, Lee Y, Lary CW, Kiel DP, Berry SD. Predictors of hip fracture despite treatment with bisphosphonates among frail older adults. Journal of the American Geriatrics Society. 2020;68(2):256-60.
  13. Rincon Gomez M, Hernandez Quiles C, Garcia Gutierrez M, Galindo Ocana J, Parra Alcaraz R, Alfaro Lara V, et al. Hip fracture co-management in the elderly in a tertiary referral hospital: A cohorts study. Revista clinica espanola. 2020;220(1):1-7.
  14. Gamboa-Arango A, Duaso E, Formiga F, Marimon P, Sandiumenge M, Salgado MT, et al. Pronostic factors of good functionality at 12 months of a hip fracture. Maluc Anoia study. Revista espanola de cirugia ortopedica y traumatologia. 2020;64(1):57-63.
  15. Jamieson HA, Nishtala PS, Scrase R, Deely JM, Abey-Nesbit R, Hilmer SN, et al. Drug burden index and its association with hip fracture among older adults: a national population-based study. The Journals of Gerontology: Series A. 2019;74(7):1127-33.
  16. Chinoy MA, Gulzar Naqvi SZ, Khan MA, Ahmed SK, Muhammad MG. Nottingham Hip Fracture Score as a predictor of 3 months postoperative mortality in patients undergoing surgical fixation of hip fractures: A prospective study. JPMA The Journal of the Pakistan Medical Association. 2020;70(Suppl 1)(2):S3-s5.
  17. Marufu TC, Elphick HL, Ahmed FB, Moppett IK. Short-term morbidity factors associated with length of hospital stay (LOS): Development and validation of a Hip Fracture specific postoperative morbidity survey (HF-POMS). Injury. 2019;50(4):931-8.
  18. Sullivan KJ, Husak LE, Altebarmakian M, Brox WT. Demographic factors in hip fracture incidence and mortality rates in California, 2000–2011. Journal of orthopaedic surgery and research. 2016;11(1):4.
  19. Frisch NB, Wessell N, Charters M, Greenstein A, Shaw J, Peterson E, et al. Hip Fracture Mortality: Differences Between Intertrochanteric and Femoral Neck Fractures. Journal of surgical orthopaedic advances. 2018;27(1):64-71.
  20. Tebé C, Martínez-Laguna D, Carbonell-Abella C, Reyes C, Moreno V, Diez-Perez A, et al. The association between type 2 diabetes mellitus, hip fracture, and post-hip fracture mortality: a multi-state cohort analysis. Osteoporosis International. 2019;30(12):2407-15.
  21. Xu B, Han L, Liu H, Wang J, Bao X-Y, Xi H-X, et al. Cardiovascular disease and hip fracture among older inpatients in Beijing, China. BioMed research international. 2013.
  22. Ruths S, Bakken MS, Ranhoff AH, Hunskaar S, Engesæter LB, Engeland A. Risk of hip fracture among older people using antihypertensive drugs: a nationwide cohort study. BMC geriatrics. 2015;15(1):153.
  23. Bakken MS, Engeland A, Engesæter LB, Ranhoff AH, Hunskaar S, Ruths S. Risk of hip fracture among older people using anxiolytic and hypnotic drugs: a nationwide prospective cohort study. European journal of clinical pharmacology. 2014;70(7):873-80.
  24. Wolinsky FD, Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, et al. Recent hospitalization and the risk of hip fracture among older Americans. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2009;64(2):249-55.
  25. Chen JS, Sambrook PN, Simpson JM, Cameron ID, Cumming RG, Seibel MJ, et al. Risk factors for hip fracture among institutionalised older people. Age and ageing. 2009;38(4):429-34.
  26. Mukamal K, Robbins JA, Cauley J, Kern L, Siscovick D. Alcohol consumption, bone density, and hip fracture among older adults: the cardiovascular health study. Osteoporosis international. 2007;18(5):593-602.
  27. Tromp A, Smit J, Deeg D, Bouter L, Lips P. Predictors for falls and fractures in the Longitudinal Aging Study Amsterdam. Journal of bone and mineral research. 1998;13(12):1932-9.
  28. Hu F, Jiang C, Shen J, Tang P, Wang Y. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2012;43(6):676-85.
  29. Choi J-Y, Cho K-J, Kim S-w, Yoon S-J, Kang M-g, Kim K-i, et al. Prediction of mortality and postoperative complications using the hip-multidimensional frailty score in elderly patients with hip fracture. Scientific reports. 2017;7:42966.
  30. Rostagno C, Buzzi R, Campanacci D, Boccacini A, Cartei A, Virgili G, et al. In hospital and 3-month mortality and functional recovery rate in patients treated for hip fracture by a multidisciplinary team. PloS one. 2016;11(7).
  31. Novoa-Parra CD, Hurtado-Cerezo J, Morales-Rodriguez J, Sanjuan-Cervero R, Rodrigo-Perez JL, Lizaur-Utrilla A. Factors predicting one-year mortality of patients over 80 years operated after femoral neck fracture. Revista espanola de cirugia ortopedica y traumatologia. 2019;63(3):202-8.
  32. Karres J, Kieviet N, Eerenberg JP, Vrouenraets BC. Predicting Early Mortality After Hip Fracture Surgery: The Hip Fracture Estimator of Mortality Amsterdam. Journal of orthopaedic trauma. 2018;32(1):27-33.
  33. Tsang C, Boulton C, Burgon V, Johansen A, Wakeman R, Cromwell D. Predicting 30-day mortality after hip fracture surgery: evaluation of the National Hip Fracture Database case-mix adjustment model. Bone & joint research. 2017;6(9):550-6.
  34. Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study. Archives of osteoporosis. 2017;12(1):67.
  35. Von Friesendorff M, McGuigan FE, Wizert A, Rogmark C, Holmberg AH, Woolf AD, et al. Hip fracture, mortality risk, and cause of death over two decades. Osteoporosis International. 2016;27(10):2945-53.

How to Cite

Amin, A., Ali, H. H. H., Faraji, S. A., Ghafoor, S. N., Shareef, S. H., Sadeq, S., Noori, S., Ghareeb, K. A. H., & Gubari, M. I. M. (2020). Hip fracture among elderly people: a single cohort study from Kurdistan of Iraq. Bali Medical Journal, 9(3), 934–939. https://doi.org/10.15562/bmj.v9i3.1970
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Asso Amin
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Hersh Haider Hama Ali
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Saman Anwar Faraji
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Sara Noori Ghafoor
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Saman Hama Shareef
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Saman Sadeq
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Soran Noori
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Khalid Anwar Hama Ghareeb
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Mohammed Ibrahim Mohialdeen Gubari
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