Clinical management of hip fractures in elderly patients with dementia and postoperative 30-day mortality: A population-based cohort study
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Clinical management of hip fractures in elderly patients with dementia and postoperative 30-day mortality : A population-based cohort study. / Petersen, Jindong Ding; Siersma, Volkert Dirk; Wehberg, Sonja; Nielsen, Connie Thurøe; Viberg, Bjarke; Waldorff, Frans Boch.
In: Brain and Behavior, Vol. 10, No. 11, e01823, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical management of hip fractures in elderly patients with dementia and postoperative 30-day mortality
T2 - A population-based cohort study
AU - Petersen, Jindong Ding
AU - Siersma, Volkert Dirk
AU - Wehberg, Sonja
AU - Nielsen, Connie Thurøe
AU - Viberg, Bjarke
AU - Waldorff, Frans Boch
PY - 2020
Y1 - 2020
N2 - Objectives: Patients with dementia have an increased 30-day mortality after hip fracture. We investigated clinical management including time to surgery, out-of-hours admission and surgery, surgery on weekends, surgery volume per ward, and anesthesia technique for this excess mortality risk. Method: This register- and population-based study comprised 12,309 older adults (age 70+) admitted to hospital for a first-time hip fracture in 2013–2014, of whom 11,318 underwent hip fracture surgery. Cox proportional hazards regression models were applied for the analysis. Results: The overall postoperative 30-day mortality was 11.4%. Patients with dementia had a 1.5 times increased mortality risk than those without (HR = 1.50 [95% CI 1.31–1.72]). We observed no time-to-surgery difference by patient dementia status; additionally, the excess mortality risk in patients with dementia could not be explained by the clinical management factors we examined. Conclusions: Increased mortality in patients with dementia could not be explained by the measured preoperative clinical management. Suboptimal handling of postoperative complication and rehabilitation are to be investigated for their role in the witnessed increased mortality for patients with dementia.
AB - Objectives: Patients with dementia have an increased 30-day mortality after hip fracture. We investigated clinical management including time to surgery, out-of-hours admission and surgery, surgery on weekends, surgery volume per ward, and anesthesia technique for this excess mortality risk. Method: This register- and population-based study comprised 12,309 older adults (age 70+) admitted to hospital for a first-time hip fracture in 2013–2014, of whom 11,318 underwent hip fracture surgery. Cox proportional hazards regression models were applied for the analysis. Results: The overall postoperative 30-day mortality was 11.4%. Patients with dementia had a 1.5 times increased mortality risk than those without (HR = 1.50 [95% CI 1.31–1.72]). We observed no time-to-surgery difference by patient dementia status; additionally, the excess mortality risk in patients with dementia could not be explained by the clinical management factors we examined. Conclusions: Increased mortality in patients with dementia could not be explained by the measured preoperative clinical management. Suboptimal handling of postoperative complication and rehabilitation are to be investigated for their role in the witnessed increased mortality for patients with dementia.
KW - 30-day mortality
KW - clinical management
KW - dementia
KW - hip fracture surgery
U2 - 10.1002/brb3.1823
DO - 10.1002/brb3.1823
M3 - Journal article
C2 - 32892489
AN - SCOPUS:85090185116
VL - 10
JO - Brain and Behavior
JF - Brain and Behavior
SN - 2157-9032
IS - 11
M1 - e01823
ER -
ID: 248758482