ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
The relationship and predictive value of dementia and frailty for mortality in patients with surgically managed hip fractures.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Vitamin D and hip protectors in osteosarcopenia: a combined hip fracture preventing approach.Reviews in endocrine & metabolic disorders · 2025Review
- Comparative Analysis of Frailty Scores for Predicting Adverse Outcomes in Hip Fracture Patients: Insights from the United States National Inpatient Sample.Journal of personalized medicine · 2024Article
- The relationship and predictive value of dementia and frailty for mortality in patients with surgically managed hip fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- The relationship and predictive value of dementia and frailty for mortality in patients with surgically managed hip fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Focus on the proximal femur.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoth dementia and frailty have been associated with worse outcomes in patients with hip fractures. However, the interrelation and predictive value of these two entities has yet to be clarified. The current study aimed to investigate the predictive relationship between dementia, frailty, and in-hospital mortality after hip fracture surgery.
methodsAll patients registered in the 2019 National Inpatient Sample Database who were 50 years or older and underwent emergency hip fracture surgery following a traumatic fall were eligible for inclusion. Logistic regression (LR) models were constructed with in-hospital mortality as the response variables. One model was constructed including markers of frailty and one model was constructed excluding markers of frailty [Orthopedic Frailty Score (OFS) and weight loss]. The feature importance of all variables was determined using the permutation importance method. New LR models were then fitted using the top ten most important variables. The area under the receiver-operating characteristic curve (AUC) was used to compare the predictive ability of these models.
resultsAn estimated total of 216,395 patients were included. Dementia was the 7th most important variable for predicting in-hospital mortality. When the OFS and weight loss were included, they replaced dementia in importance. There was no significant difference in the predictive ability of the models when comparing the model that included markers of frailty [AUC for in-hospital mortality (95% CI) 0.79 (0.77-0.81)] with the model that excluded markers of frailty [AUC for in-hospital mortality (95% CI) 0.79 (0.77-0.80)].
conclusionDementia functions as a surrogate for frailty when predicting in-hospital mortality in hip fracture patients. This finding highlights the importance of early frailty screening for improvement of care pathways and discussions with patients and their families in regard to expected outcomes.
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