Evidence map›Paper›PMID 41082891›Full record

ArticleThe lancet. Healthy longevity2025

Impact of hip fracture on survival, disability, pain, and health-related quality of life in Zimbabwe: a prospective cohort study.

Mohamad I Nasser, Anya Burton, Hannah Wilson, Tadios Manyanga, Tafadzwa Madanhire, Prudance Mushayavanhu, Munyaradzi Ndekwere, Joseph Chipanga, Samuel Hawley, Simon Matthew Graham and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The lancet. Healthy longevity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Hip fracture care in Africa: Time for action.PLOS global public health · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Mohamad I NasserMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK.
Anya BurtonMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK.
Hannah WilsonMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK.
Tadios ManyangaThe Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe.
Tafadzwa MadanhireMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK; The Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe.
Prudance MushayavanhuDepartment of Surgery, Sally Mugabe Central Hospital, Harare, Zimbabwe; Department of Surgery, Midlands State University, Gweru, Zimbabwe.
Munyaradzi NdekwereDepartment of Surgery, Midlands State University, Gweru, Zimbabwe.
Joseph ChipangaThe Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe.
Samuel HawleyMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK.
Simon Matthew GrahamOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
James MastersOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Kate A WardMRC Lifecourse Epidemiology Centre, Human Development and Health, University of Southampton, Southampton, UK; MRC Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul, The Gambia.
Matthew L CostaOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Rashida A FerrandThe Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Celia L GregsonMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK; The Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe. Electronic address: celia.gregson@bristol.ac.uk.

Funding

Wellcome Trust 217135
6 · The paper itself

Abstract

backgroundThe population in Africa is ageing, and fragility fractures increasing. We assessed 1-year health outcomes following hip fracture in older adults in Zimbabwe.

methodsIn this prospective cohort study, a cohort of adults aged 40 years or older with hip fracture, presenting to hospitals in Harare (two public and five private hospitals) between Oct 15, 2021, and Oct 14, 2022, were followed up for 12 months. The primary outcome was survival, analysed with Kaplan-Meier curves at different timepoints (30 days, 120 days, 6-8 months, and 12 months after case identification), overall and stratified by age (<70 years vs ≥70 years), delay to presentation (no delay [≤2 weeks] vs delay [>2 weeks]), and facility type and operative management. We also quantified health-related quality of life (HRQoL), measured with 5-level EQ-5D (EQ-5D-5L), hip pain, self-reported from 0 (none) to 5 (all the time) and measured as interference with walking and sleep (1 [no interference] to 10 [complete interference]), as per the Brief Pain Inventory, and disability, measured with the WHO Disability Assessment Schedule version 2.0 (WHODAS).

findingsOf 196 patients with hip fracture (96 [49%] female, 100 [51%] male; median age 74 years [IQR 62·5-83]), 162 (83%) had had a fragility fracture (low-energy trauma). In total, 173 (88%) were managed in a public hospital, of whom 96 (55%) received operative hip fixation. In contrast, all of the 23 (12%) managed in private facilities had an operation. After 12 months, 55 (29%) had died (49 [42%] of 117 patients aged ≥70 years, and six [9%] of 70 patients aged <70 years). In public hospitals, 31 (42%) of 73 non-operated patients died, compared with 18 (19%) of 93 patients who were operated on. Overall, survival declined to 88% (95% CI 82-92) by 30 days and to 71% (64-77) by 12 months. The probability of survival was lower in patients aged 70 years or older than in those younger than 70 years (mortality hazard ratio for ≥70 years 6·10, 95% CI 2·61-14·22). The mean HRQoL utility score decreased from 0·81 (95% CI 0·80-0·83) pre-fracture to 0·29 (0·25-0·34) at 30 days post fracture. Minimal recovery was seen after 120 days (0·34, 0·29-0·39). By 12 months, 97 (97%) of 100 patients alive and able to provide data still reported pain from their hip injury. Post-fracture disability was almost universal, with only two (2%) of 100 patients being disability-free (WHODAS=0) by 12 months.

interpretationFollowing hip fracture, survival and quality of life decreased substantially in the study population. These findings reveal the need for the implementation of guidelines to standardise care and improve operative capacity to manage the predicted rise in fractures in this region.

fundingWellcome Trust.

Indexed as

Hip FracturesPainPersons with DisabilitiesQuality of LifeAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesZimbabwe

Identifiers

PMID41082891
PMCPMC7618745

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.