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Patients Aged 80 or More With Distal Radius Fractures Have a Lower One-Year Mortality Rate Than Age- and Gender-Matched Controls : A Register-Based Study

Arvidsson, Linnea LU ; Landgren, Marcus ; Harding, Anna Kajsa LU ; Abramo, Antonio LU and Tägil, Magnus LU (2024) In Geriatric Orthopaedic Surgery and Rehabilitation 15.
Abstract

Introduction: With a rapidly ageing population, the number of distal radius fractures (DRFs) in the elderly will increase dramatically. The aim of this retrospective register study was to examine the 1- and 5-year mortality in DRF patients aged 80 years or more and correlate the overall survival to factors not related to the fracture itself. Material and Methods: Patients aged ≥80 diagnosed with DRFs in Lund University Hospital in Sweden in the period 2010-2012 were extracted from the prospective Lund Distal Radius Fracture register. One- and 5-year standardised mortality rates (SMRs) were calculated using the Swedish standard population as a reference. Medical records were searched for non-fracture-related factors including... (More)

Introduction: With a rapidly ageing population, the number of distal radius fractures (DRFs) in the elderly will increase dramatically. The aim of this retrospective register study was to examine the 1- and 5-year mortality in DRF patients aged 80 years or more and correlate the overall survival to factors not related to the fracture itself. Material and Methods: Patients aged ≥80 diagnosed with DRFs in Lund University Hospital in Sweden in the period 2010-2012 were extracted from the prospective Lund Distal Radius Fracture register. One- and 5-year standardised mortality rates (SMRs) were calculated using the Swedish standard population as a reference. Medical records were searched for non-fracture-related factors including comorbidity, medications, cognitive impairment and type of living. Cox proportional hazard regression models were used to identify prognostic factors for all-cause mortality. Results: The study cohort included 240 patients, with a mean age of 86. The overall 1-year mortality was 5% (n = 11/240) and the 5-year mortality was 44% (n = 105/240). The 1-year SMR was.44 (CI.18-.69, P <.01) when indirectly adjusted for age and gender and compared to the Swedish standard population. The 5-year SMR was.96 (CI.78-1.14). The patients’ ability to live independently in their own home had the highest impact on survival. Discussion: The 1-year mortality rate among the super-elderly DRF patients was only 44% of that expected. Possibly, a DRF at this age could be a sign of a healthier and more active patient. Conclusions: The DRF patients aged 80 or more had a substantially lower mortality rate 1 year after fracture compared to the age- and gender-matched standard population. Patients living independently in their own homes had the longest life expectancy. Treatment should not be limited solely because of old age, but individualised according to the patient’s ability and activity level.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
distal radius fracture, fragility fractures, geriatric trauma, mortality, trauma surgery, upper extremity surgery
in
Geriatric Orthopaedic Surgery and Rehabilitation
volume
15
publisher
SAGE Publications
external identifiers
  • pmid:38711473
  • scopus:85192183584
ISSN
2151-4585
DOI
10.1177/21514593241252583
language
English
LU publication?
yes
id
8c208da3-f9d5-4501-820c-064c9ce7e45c
date added to LUP
2024-05-16 14:26:10
date last changed
2024-06-13 17:11:48
@article{8c208da3-f9d5-4501-820c-064c9ce7e45c,
  abstract     = {{<p>Introduction: With a rapidly ageing population, the number of distal radius fractures (DRFs) in the elderly will increase dramatically. The aim of this retrospective register study was to examine the 1- and 5-year mortality in DRF patients aged 80 years or more and correlate the overall survival to factors not related to the fracture itself. Material and Methods: Patients aged ≥80 diagnosed with DRFs in Lund University Hospital in Sweden in the period 2010-2012 were extracted from the prospective Lund Distal Radius Fracture register. One- and 5-year standardised mortality rates (SMRs) were calculated using the Swedish standard population as a reference. Medical records were searched for non-fracture-related factors including comorbidity, medications, cognitive impairment and type of living. Cox proportional hazard regression models were used to identify prognostic factors for all-cause mortality. Results: The study cohort included 240 patients, with a mean age of 86. The overall 1-year mortality was 5% (n = 11/240) and the 5-year mortality was 44% (n = 105/240). The 1-year SMR was.44 (CI.18-.69, P &lt;.01) when indirectly adjusted for age and gender and compared to the Swedish standard population. The 5-year SMR was.96 (CI.78-1.14). The patients’ ability to live independently in their own home had the highest impact on survival. Discussion: The 1-year mortality rate among the super-elderly DRF patients was only 44% of that expected. Possibly, a DRF at this age could be a sign of a healthier and more active patient. Conclusions: The DRF patients aged 80 or more had a substantially lower mortality rate 1 year after fracture compared to the age- and gender-matched standard population. Patients living independently in their own homes had the longest life expectancy. Treatment should not be limited solely because of old age, but individualised according to the patient’s ability and activity level.</p>}},
  author       = {{Arvidsson, Linnea and Landgren, Marcus and Harding, Anna Kajsa and Abramo, Antonio and Tägil, Magnus}},
  issn         = {{2151-4585}},
  keywords     = {{distal radius fracture; fragility fractures; geriatric trauma; mortality; trauma surgery; upper extremity surgery}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{Geriatric Orthopaedic Surgery and Rehabilitation}},
  title        = {{Patients Aged 80 or More With Distal Radius Fractures Have a Lower One-Year Mortality Rate Than Age- and Gender-Matched Controls : A Register-Based Study}},
  url          = {{http://dx.doi.org/10.1177/21514593241252583}},
  doi          = {{10.1177/21514593241252583}},
  volume       = {{15}},
  year         = {{2024}},
}