A Comparison of Patients with Hip Fracture, Ten Years Apart: Morbidity, Malnutrition and Sarcopenia
- PDF / 538,120 Bytes
- 8 Pages / 612 x 792 pts (letter) Page_size
- 86 Downloads / 168 Views
A COMPARISON OF PATIENTS WITH HIP FRACTURE, TEN YEARS APART: MORBIDITY, MALNUTRITION AND SARCOPENIA N. PROBERT1,2, A. LÖÖW3, G. AKNER4, P. WRETENBERG1,5, Å.G. ANDERSSON1,6 1. Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 2. Centre of Clinical Research, Region Värmland, Sweden; 3. School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 4. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; 5. Department of Orthopaedics, Örebro University Hospital, Örebro, Sweden; 6. Department of Geriatrics, Örebro University Hospital, Örebro, Sweden. Corresponding author: Noelle Probert, MD, Faculty of Medicine and Health, Örebro University, Örebro, Sweden, [email protected]
Abstract: Objectives: To investigate possible differences in morbidity, malnutrition, sarcopenia and specific drug use in patients with hip fracture, ten years apart. To analyse 1-year mortality and possible associations with variables. Design: A prospective, observational study. Setting: Örebro University Hospital, Sweden. Participants: Two cohorts of patients with hip fracture, included in 2008 (n=78) and 2018 (n=76). Measurements: Presence of comorbidity according to the Elixhauser comorbidity measure, multimorbidity defined as ≥3 comorbidities, preoperative American Society of Anaesthesiologists Classification (ASA-class), malnutrition according to the definition by the Global Leadership Initiative on Malnutrition (GLIM), sarcopenia according to the most recently revised definition by the European Working Group on Sarcopenia in Older People (EWGSOP), polypharmacy defined as ≥5 prescribed medications, use of Potentially Inappropriate Medications (PIM) and Fall-Risk-Increasing-Drugs (FRID) and postoperative 1-year mortality. Results: When comparing the cohorts, significant increases over time was seen for mean comorbidity-count (Difference -1; p=0.002), multimorbidity (Difference -15%; 95%CI -27;-2), ASA-class 3-4 (Difference -25%; 95%CI -39;-9) and polypharmacy (Difference -17%; 95%CI -32;-2). Prevalence of malnutrition and sarcopenia coherently decreased with 22% (95%CI 5;37) and 14% (95%CI 1;29) respectively. One-year mortality remained unchanged and a significant association was found for a higher ASA-class in 2008 (OR 3.5, 95%CI 1.1;11.6) when adjusted for age. Results on PIM exposure suggest a decrease while exposure to FRID remained high. Conclusion: Our findings support an increasing morbidity within the population over time. However, also presented is a coherent decrease in malnutrition and sarcopenia, suggesting a decrease in frailty as a possible explanation for the observed unaltered mortality, in turn suggesting advances in treatment of comorbidities. Key words: Hip fracture, comorbidity, malnutrition, sarcopenia, mortality.
Introduction
in studies. Older people and particularly patients with hip fracture have a vulnerability to Potentially Inappropriate Medications (PIM), associated with increased mortality postfracture (18). Fall-Risk-
Data Loading...
