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A combined fracture and mortality risk index useful for treatment stratification in hip fragility fractures

Sezgin, Erdem Aras LU ; Tor, Ahmet Toygun ; Markevičiūtė, Vėtra ; Širka, Aurimas ; Tarasevičius, Šarūnas LU ; Raina, Deepak Bushan LU ; Liu, Yang LU ; Isaksson, Hanna LU orcid ; Tägil, Magnus LU and Lidgren, Lars LU (2021) In Joint Diseases and Related Surgery 32(3). p.583-589
Abstract

Objectives: In this study, we aimed to assess the stratification ability of the Fracture and Mortality Risk Evaluation (FAME) index for reoperation, new fragility fracture, and mortality during one-year follow-up. Patients and methods: Between November 2018 and July 2019, a total of 94 consecutive hip fragility fracture patients from two centers (20 males, 74 females; mean age: 79.3±8.9 years; range, 57 to 100 years) were retrospectively analyzed. The patients were classified into high, intermediate, and low fracture and mortality risk groups according to the Fracture Risk Assessment Tool (FRAX) score and Sernbo score, respectively, as well as nine combined categories according to the FAME index. Hospital records were reviewed to... (More)

Objectives: In this study, we aimed to assess the stratification ability of the Fracture and Mortality Risk Evaluation (FAME) index for reoperation, new fragility fracture, and mortality during one-year follow-up. Patients and methods: Between November 2018 and July 2019, a total of 94 consecutive hip fragility fracture patients from two centers (20 males, 74 females; mean age: 79.3±8.9 years; range, 57 to 100 years) were retrospectively analyzed. The patients were classified into high, intermediate, and low fracture and mortality risk groups according to the Fracture Risk Assessment Tool (FRAX) score and Sernbo score, respectively, as well as nine combined categories according to the FAME index. Hospital records were reviewed to identify re-fractures (reoperations, implant failure, new fragility fractures on any site) and mortality at one year following the FAME index classification. Results: Overall re-fracture and mortality rates were 20.2% and 33%, respectively. High fracture risk category (FRAX-H) was significantly associated with higher re-fracture (odds ratio [OR]: 2.9, 95% confidence interval [CI]: 1-8.2, p=0.037) and mortality rates compared to others (OR: 3.7, 95% CI: 1.5-9.3, p=0.003). The patients classified within the FRAX-H category (n=35) had different mortality rates according to their Sernbo classification; i.e., patients classified as low mortality risk (Sernbo-L) (n=17) had lower mortality rates compared to others in this group (n=18) (35.3% and 66.7%, respectively), indicating a low statistical significance (OR: 0.3, 95% CI: 0.1-1.1, p=0.063). Similarly, within patients classified in Sernbo-L category (n=64), those classified as high fracture risk (FRAX-H) (n=17) had significantly higher re-fracture rates compared to others in this group (n=47) (35.3% and 8.5%, respectively), (OR: 5.9; 95% CI: 1.4-24.5), (p=0.017). Multivariate logistic regression analyses adjusting for covariates (age, sex, length of hospital stay and BMI) yielded similar results. Conclusion: The FAME index appears to be a useful stratification tool for allocating patients in a randomized-controlled trial for augmentation of hip fragility fractures.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Augmentation, hip fracture, osteoporosis, risk factors, stratification
in
Joint Diseases and Related Surgery
volume
32
issue
3
pages
7 pages
publisher
Turkish Joint Diseases Foundation
external identifiers
  • scopus:85121264575
  • pmid:34842088
ISSN
2687-4784
DOI
10.52312/JDRS.2021.382
language
English
LU publication?
yes
id
cd1e67af-7c82-4a10-80e2-078e26e3816b
date added to LUP
2022-01-31 15:05:15
date last changed
2024-06-16 00:44:45
@article{cd1e67af-7c82-4a10-80e2-078e26e3816b,
  abstract     = {{<p>Objectives: In this study, we aimed to assess the stratification ability of the Fracture and Mortality Risk Evaluation (FAME) index for reoperation, new fragility fracture, and mortality during one-year follow-up. Patients and methods: Between November 2018 and July 2019, a total of 94 consecutive hip fragility fracture patients from two centers (20 males, 74 females; mean age: 79.3±8.9 years; range, 57 to 100 years) were retrospectively analyzed. The patients were classified into high, intermediate, and low fracture and mortality risk groups according to the Fracture Risk Assessment Tool (FRAX) score and Sernbo score, respectively, as well as nine combined categories according to the FAME index. Hospital records were reviewed to identify re-fractures (reoperations, implant failure, new fragility fractures on any site) and mortality at one year following the FAME index classification. Results: Overall re-fracture and mortality rates were 20.2% and 33%, respectively. High fracture risk category (FRAX-H) was significantly associated with higher re-fracture (odds ratio [OR]: 2.9, 95% confidence interval [CI]: 1-8.2, p=0.037) and mortality rates compared to others (OR: 3.7, 95% CI: 1.5-9.3, p=0.003). The patients classified within the FRAX-H category (n=35) had different mortality rates according to their Sernbo classification; i.e., patients classified as low mortality risk (Sernbo-L) (n=17) had lower mortality rates compared to others in this group (n=18) (35.3% and 66.7%, respectively), indicating a low statistical significance (OR: 0.3, 95% CI: 0.1-1.1, p=0.063). Similarly, within patients classified in Sernbo-L category (n=64), those classified as high fracture risk (FRAX-H) (n=17) had significantly higher re-fracture rates compared to others in this group (n=47) (35.3% and 8.5%, respectively), (OR: 5.9; 95% CI: 1.4-24.5), (p=0.017). Multivariate logistic regression analyses adjusting for covariates (age, sex, length of hospital stay and BMI) yielded similar results. Conclusion: The FAME index appears to be a useful stratification tool for allocating patients in a randomized-controlled trial for augmentation of hip fragility fractures.</p>}},
  author       = {{Sezgin, Erdem Aras and Tor, Ahmet Toygun and Markevičiūtė, Vėtra and Širka, Aurimas and Tarasevičius, Šarūnas and Raina, Deepak Bushan and Liu, Yang and Isaksson, Hanna and Tägil, Magnus and Lidgren, Lars}},
  issn         = {{2687-4784}},
  keywords     = {{Augmentation; hip fracture; osteoporosis; risk factors; stratification}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{583--589}},
  publisher    = {{Turkish Joint Diseases Foundation}},
  series       = {{Joint Diseases and Related Surgery}},
  title        = {{A combined fracture and mortality risk index useful for treatment stratification in hip fragility fractures}},
  url          = {{http://dx.doi.org/10.52312/JDRS.2021.382}},
  doi          = {{10.52312/JDRS.2021.382}},
  volume       = {{32}},
  year         = {{2021}},
}