The risk factors and mortality in elderly patients with different glomerular filtration rate after hip fracture

Abstract

Abstract Background: The aim of our study was to explore short- and long-term mortality and risk factors affecting Chinese elderly patients with different glomerular filtration rate after hip fracture. Methods: This study included 513 patients aged≥65 years old and first been diagnosed with hip fracture in the Department Orthopedics of Huadong hospital between January 1st, 2010 and December 31st, 2011. Patients’ medical records were collected from the electronic medical record system. Survival status after hip fracture were assessed through telephone interviews and causes of death were verified. The patients were divided into three groups according to the renal function. Kaplan-Meier survival analysis was used to compare survival time between different groups. Univariate and multivariate Cox proportional hazards model was constructed to analyze differences between patients and factors associated with mortality. Results: According to the inclusion and exclusion criteria and excluded patients who were lost to follow-up, a total of 325 patients were available in this study. Of which 73.5% were female and 85.2% received surgical operation. One-year cumulative mortality were 9.30%, 19.81% and 22.53% for group 1, 2 and 3. Five-year cumulative mortality were21.87%, 55.86% and 78.87%, while the ten-year cumulative mortality were40.61%, 74.32% and 94.37% respectively. Our analysis found that age (1.076 (1.031-1.122)), cognitive function (2.279(1.101-4.718)) were associated with higher risk of one-year mortality. Age (1.062(1.035-1.090)), eGFR<60 mL/min/1.73m2(2.425(1.054-5.578)) were associated with higher risk of five-year mortality. Age(1.073(1.049-1.097)), eGFR<60 mL/min/1.73m2(2.120(1.110-4.048)) and mildly decreased cognitive function(1.949(1.163-3.265)) were associated with higher risk of ten-year mortality. Conclusion: Renal function seem to have little effect on short term mortality of Chinese elderly patients after hip fracture, but was an important risk factor affecting the medium to long-term mortality. For patients with decreased eGFR, fully evaluating the status of patients and choosing appropriate surgical method as soon as possible after fracture can greatly reduce the risk of death and ensure better survival in the elderly.