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논문 기본 정보

자료유형
학술저널
저자정보
Ha Yong-Chan (Department of Orthopaedic Surgery Chung-Ang University College of Medicine Seoul Korea.) Cha Yonghan (Department of Orthopaedic Surgery Daejeon Eulji Medical Center Eulji University School of Medicine) Yoo Jun-Il (Department of Orthopaedic Surgery Gyeongsang National University Hospital Jinju Korea.) Lee Jiyoon (Department of Orthopaedic Surgery Daejeon Eulji Medical Center Eulji University School of Medicine) Lee Young-Kyun (Department of Orthopaedic Surgery Seoul National University Bundang Hospital Seongnam Korea.) Koo Kyung-Hoi (Department of Orthopaedic Surgery Seoul National University Bundang Hospital Seongnam Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.38
발행연도
2021.10
수록면
1 - 8 (8page)
DOI
10.3346/jkms.2021.36.e238

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Background: The aim of this study was to assess the prevalence of dementia as an underlying disease in elderly patients with hip fracture, to investigate the effect of dementia on postoperative mortality after surgery of hip fracture, and to analyze the differences in postoperative mortalities according to the severity of dementia through subgroup analysis. Methods: This study selected 2,346 elderly patients who were diagnosed with unilateral intertrochanteric or femoral neck fractures who underwent surgery between January 2004 and December 2018. The patients were classified into the non-dementia group (2,196 patients) and dementia group (150 patients; no-medication [66 patients] and medication [84 patients] subgroups). The cumulative crude mortality rate was calculated, and 30-day, 60-day, 3-month, 6-month, and 1-year mortality rates were compared between the groups. A univariate regression test was performed using age, sex, diagnosis, surgery type, and Charlson's comorbidity index (CCI), as these variables had P values of < 0.10. Multivariate regression analysis was performed to identify independent risk factors associated with mortality. Results: The 30-day, 60-day, 3-month, 6-month, and 1-year postoperative cumulative mortality rates were 1.8%, 3.8%, 5.6%, 8.9%, and 13.6%, respectively, in the non-dementia group, and 2%, 7.3%, 14%, 19.3%, and 24%, respectively, in the dementia group (P = 0.748, P = 0.048, P < 0.001, P < 0.001, and P = 0.001). The factors that affected the 1-year mortality were age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02?1.08; P < 0.001), sex (OR, 2.68; 95% CI, 2.07?3.47; P < 0.001), CCI (OR, 1.34; 95% CI, 1.23?1.47; P < 0.001), and dementia (OR, 1.70; 95% CI, 1.46?1.08; P = 0.016). In subgroup analysis, severity of dementia influenced the 6-month mortality (OR, 1.41; 95% CI, 1.70?2.01; P = 0.018), and 1-year mortality (OR, 1.30; 95% CI, 1.17?1.90; P = 0.027). Conclusion: In elderly hip fracture patients, the comparison between patients with and without dementia revealed that dementia was an independent risk factor for mortality at a minimum of 1 year of follow-up, and the severity of dementia in hip fracture patients was a risk factor for mortality within 6 months and 1 year, postoperatively.
#Hip Fracture #Mortality #Dementia #Risk Factor #Mini-Mental State Examination

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참고문헌 (23)

참고문헌 신청
Cha YH / 2017 / Effect of causes of surgical delay on early and late mortality in patients with proximal hip fracture / Arch Orthop Trauma Surg 137(5):625~630 google schola 박용근 / 2014 / Incidence, Morbidity and Mortality in Patients Older than 50 Years with Second Hip Fracture in a Jeju Cohort Study / Hip and Pelvis 26(4):250~255 dbpia Hasegawa Y / 2007 / Risk of mortality following hip fracture in Japan / J Orthop Sci 12(2):113~117 google schola Ireland AW / 2015 / Risk factor profiles for early and delayed mortality after hip fracture : analyses of linked Australian Department of Veterans' Affairs databases / Injury 46(6):1028~1035 google schola Härstedt M / 2015 / Impact of comorbidity on 6-month hospital readmission and mortality after hip fracture surgery / Injury 46(4):713~718 google schola

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