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Open AccessArticle

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

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Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2
Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai 50200, Thailand
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Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
6
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(6), 311; https://doi.org/10.3390/medicina56060311
Received: 16 May 2020 / Revised: 18 June 2020 / Accepted: 22 June 2020 / Published: 24 June 2020
(This article belongs to the Section Surgery)
Background and Objectives: Although the types of comorbidities and laboratory evaluations are major factors associated with mortality after hip fractures, there have been no studies of the association of these factors and mortality in Thai hip-fracture patients. This study aimed to identify prognostic factors associated with mortality after a hip fracture in the Thai population, including types of comorbidities, treatment-related factors, and laboratory evaluations. Materials and Methods: This five-year retrospective study was conducted in a tertiary care hospital in Thailand. A total of 775 Thai patients who had been admitted with a hip fracture resulting from a simple fall were identified using the International Classification of Disease 10 codes, and a review of their medical charts was conducted. Associations between general factors, comorbidities, laboratory evaluations, treatment factors including type of treatment, and time to death were analyzed using the Cox proportional hazard regression and the hazard ratio (HR). Results: The overall mortality rate of hip fracture patients was 13.94%. Independent prognostic factors found to be significantly associated with mortality were nonoperative treatment (HR = 3.29, p < 0.001), admission glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 (HR = 3.40, p < 0.001), admission hemoglobin concentration <10 g/dL. (HR = 2.31, p < 0.001), chronic obstructive pulmonary disorder (HR = 2.63, p < 0.001), dementia or Alzheimer’s disease (HR = 4.06, p < 0.001), and active malignancy (HR = 6.80, p < 0.001). Conclusion: The types of comorbidities and laboratory evaluation findings associated with mortality in Thai patients with hip fractures include chronic obstructive pulmonary disorder, dementia or Alzheimer’s disease, active malignancy, admission GFR < 30 mL/min/1.73 m2, and admission hemoglobin concentration <10 g/dL. The risks of mortality for Thai hip-fracture patients with these comorbidities or laboratory evaluation findings were 2.5, 4, 7, 3.5, and 2.5 times higher, respectively, than patients without those factors. View Full-Text
Keywords: prognostic factors; mortality; Thai; hip fracture; comorbidities; laboratory evaluations prognostic factors; mortality; Thai; hip fracture; comorbidities; laboratory evaluations
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Atthakomol, P.; Manosroi, W.; Phinyo, P.; Pipanmekaporn, T.; Vaseenon, T.; Rojanasthien, S. Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations. Medicina 2020, 56, 311.

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