Abstract
Introduction
A prior hip fracture and increasing bone fragility can increase the risk of a secondary fracture among older adults. Frailty has been associated with readmissions and may provide a useful clinical tool to identify older hip fracture patients at-risk of fracture-related readmissions. This study examined the role of frailty risk for long-term risk of fracture-related readmission and mortality among older adults after a hip fracture.
Methods
Retrospective analysis of linked hospital admission and mortality data in New South Wales, Australia of older adults aged ≥65 years admitted after a hip fractures and discharged between 2014 to 2018, with at least 36 months follow-up post discharge. A semi-competing risk analysis examined factors associated with risk of readmission for a refracture and/or mortality adjusted for personal-level factors (e.g., sex, age, and comorbidities). The Hospital Frailty Risk Score from one-year look-back period is used to identify frailty risk.
Results
Among 28,567 patients, 9.8% were identified with low frailty, 39.4% with intermediate frailty, and 50.6% with high frailty. About 9.8% of patients were admitted with a refracture, 47.9% died, and 11.5% died post-refracture during follow-up period to 2021. Patients with intermediate (Hazard ratios (HR): 1.34, 95% confidence intervals (95%CI): 1.22-1.48) or high (HR: 1.69, 95%CI: 1.53-1.87) frailty had a higher risk of refracture than older adults with low frailty. Additionally, patients with intermediate or high frailty significantly increased risk of death.
Conclusions
Frailty risk estimated using hospital administrative data could assist to prospectively identify patients at a high risk of refracture and mortality.
A prior hip fracture and increasing bone fragility can increase the risk of a secondary fracture among older adults. Frailty has been associated with readmissions and may provide a useful clinical tool to identify older hip fracture patients at-risk of fracture-related readmissions. This study examined the role of frailty risk for long-term risk of fracture-related readmission and mortality among older adults after a hip fracture.
Methods
Retrospective analysis of linked hospital admission and mortality data in New South Wales, Australia of older adults aged ≥65 years admitted after a hip fractures and discharged between 2014 to 2018, with at least 36 months follow-up post discharge. A semi-competing risk analysis examined factors associated with risk of readmission for a refracture and/or mortality adjusted for personal-level factors (e.g., sex, age, and comorbidities). The Hospital Frailty Risk Score from one-year look-back period is used to identify frailty risk.
Results
Among 28,567 patients, 9.8% were identified with low frailty, 39.4% with intermediate frailty, and 50.6% with high frailty. About 9.8% of patients were admitted with a refracture, 47.9% died, and 11.5% died post-refracture during follow-up period to 2021. Patients with intermediate (Hazard ratios (HR): 1.34, 95% confidence intervals (95%CI): 1.22-1.48) or high (HR: 1.69, 95%CI: 1.53-1.87) frailty had a higher risk of refracture than older adults with low frailty. Additionally, patients with intermediate or high frailty significantly increased risk of death.
Conclusions
Frailty risk estimated using hospital administrative data could assist to prospectively identify patients at a high risk of refracture and mortality.
| Original language | English |
|---|---|
| Publication status | Published - 16 Nov 2023 |
| Event | 56th AAG Conference - Gold Coast, Australia Duration: 14 Nov 2023 → 17 Nov 2023 Conference number: 56 https://www.aagconference.asn.au/ |
Conference
| Conference | 56th AAG Conference |
|---|---|
| Country/Territory | Australia |
| City | Gold Coast |
| Period | 14/11/23 → 17/11/23 |
| Internet address |