Mobility and mortality outcomes among older individuals with hip fractures at a teaching hospital in Malaysia.

Autor: Khor HM; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. hmkhor@um.edu.my., Tan MP; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Kumar CS; Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Singh S; Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Tan KM; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Saedon NB; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Ong T; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Chin AV; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Kamaruzzaman SB; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Hasmukharay K; Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Zakaria MIB; Academic Unit Trauma and Emergency, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Teh HX; Department of Medicine, Hospital Sultan Ismail, Jalan Mutiara Emas Utama, Taman Mount Austin, Johor Bahru, Johor, Malaysia., Tan FC; Department of Medicine, Hospital Seberang Jaya, Jalan Tun Hussein Onn, Seberang Jaya, Permatang Pauh, Pulau Pinang, Malaysia., Chong PY; Parkcity Medical Centre, No. 2, Jalan Intisari Perdana, Desa Parkcity, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Archives of osteoporosis [Arch Osteoporos] 2022 Nov 30; Vol. 17 (1), pp. 151. Date of Electronic Publication: 2022 Nov 30.
DOI: 10.1007/s11657-022-01183-w
Abstrakt: The challenges of hip fracture care in Malaysia is scarcely discussed. This study evaluated the outcomes of older patients with hip fracture admitted to a teaching hospital in Malaysia. We found that one in five individuals was no longer alive at one year after surgery. Three out of five patients did not recover to their pre-fracture mobility status 6 months following hip fracture surgery.
Purpose: With the rising number of older people in Malaysia, it is envisaged that the number of fragility hip fractures would also increase. The objective of this study was to determine patient characteristics and long-term outcomes of hip fracture in older individuals at a teaching hospital in Malaysia.
Methods: This was a prospective observational study which included consecutive patients aged  ≥ 65 years old admitted to the orthopedic ward with acute hip fractures between March 2016 and August 2018. Patient socio-demographic details, comorbidities, pre-fracture mobility status, fracture type, operation and anesthesia procedure, and length of stay were recorded. Post-fracture mobility status was identified at 6 months. Cox proportional hazard analysis was used to assess the risk of death in all patients.
Results: 310 patients (70% women) with the mean age of 79.89 years (SD 7.24) were recruited during the study period. Of these, 284 patients (91.6%) underwent surgical intervention with a median time to surgery of 5 days (IQR 3-8) days. 60.4% of patients who underwent hip fracture surgery did not recover to their pre-fracture mobility status. One year mortality rate was 20.1% post hip fracture surgery. The independent predictor of mortality included advanced age (hazard ratio, HR = 1.05, 95% CI = 1.01-1.08; p = 0.01), dependency on activities of daily living (HR = 2.08, 95% CI = 1.26-3.45; p = 0.01), and longer length of hospitalization (HR = 1.02, 95% CI = 1.01-1.04; p < 0.01).
Conclusion: One in 5 individuals who underwent hip fracture surgery at a teaching hospital in Kuala Lumpur was no longer alive at one year. A systematic approach to hip fracture management is crucial to improve outcomes and restore pre-fracture function of this vulnerable group of patients.
(© 2022. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)
Databáze: MEDLINE
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