Older Women Need Screening For Hip Fracture Risk

MedicalResearch.com Interview with:

Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System

Dr. Ensrud

Kristine E. Ensrud MD MPH
Professor of Medicine and Epidemiology and Community Health
University of Minnesota
Core Investigator, Center for Care Delivery and Outcomes Research
Minneapolis VA Health Care System 

MedicalResearch.com: What is the background for this study?

Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population. Continue reading

Hip Fracture in Elderly: Longer Surgery and General Anesthesia Linked to Greater Risk of Post-Op Delirium

MedicalResearch.com Interview with:

Bheeshma Ravi, MD, PhD, FRCSC Scientist Sunnybrook Health Sciences Centre Holland Centre Toronto, ON

Dr. Ravi

Bheeshma Ravi, MD, PhD, FRCSC
Scientist
Sunnybrook Health Sciences Centre
Holland Centre
Toronto, ON

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Delirium is an acute change in mental status characterized by fluctuating disturbances of consciousness and attention. Elderly patients are prone to delirium after surgery; this contributes significantly to post-operative morbidity and can also lead to long-term disability.

Our study found that among older adults undergoing hip fracture surgery, both an increased duration of surgery and a general anesthetic are associated with an increased risk for post-operative delirium.​ 

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Shorter Hospital Stay For Hip Fracture Linked To Higher Mortality After Discharge

Prof. Peter Nordström Department of Community Medicine and Rehabilitation Geriatrics, Umeå University Umeå, SwedenMedicalResearch.com Interview with:
Prof. Peter Nordström

Department of Community Medicine and Rehabilitation
Geriatrics, Umeå University
Umeå, Sweden

MedicalResearch: What is the background for this study? What are the main findings?

Prof. Nordström: The number of elderly people is increasing, while the number of hospital beds is decreasing in Europe, which may be related to economic constraints and a more efficient health care. This may have contributed to a shorter length of stay in hospital after surgery. We found that a length of stay (LOS) of ten days or less was associated with a progressive increased risk of death after discharge from hospital.

MedicalResearch: What should clinicians and patients take away from your report?

Prof. Nordström: That a length of stay (LOS) of ten days or less is associated with a progressive increased risk of death after discharge from hospital in patients with a hip fracture.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Prof. Nordström: In addition to evaluation of also other diagnoses than hip fractures, further research should seek to gain a better understanding of the underlying cause of the increased risk of death after discharge in surgical patients, and evaluate whether early discharge to rehabilitation centers or nursing homes is associated with a worse outcome.

Citation:

Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden
Peter Nordström, professor, Yngve Gustafson, professor, Karl Michaëlsson, professor, Anna Nordström, associate professor

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h696 (Published 20 February 2015) Cite this as: BMJ 2015;350:h696

MedicalResearch.com Interview with: Prof. Peter Nordström (2015). Shorter Hospital Stay For Hip Fracture Linked To Higher Mortality After Discharge 

Hip Fracture Surgery: Hand Grip Strength and Recovery Prediction

MedicalResearch.com Interview with:
Stefano Volpato MD MPH
Department of Medical Sciences, University of Ferrara
Ferrara, Italy

MedicalResearch.com: What are the main findings of the study?

Dr. Volpato: In this study we evaluated clinical value of handgrip strength  assessment in older patients admitted to the hospital for hip fracture. We observed 504 older patients admitted to 4 Italian hospitals for hip surgery, able of walking independently before fracture, and we found a strong, graded and independent association of grip strength, assessed before hip surgery, and the likelihood of functional recovery over the one-year follow-up. The findings reported in our manuscript can be summarized as:

a. handgrip strength significantly correlated with several prognostic factors traditionally considered in clinical practice, such as age, gender, neuro-psychological and functional status, comorbidity level, vitamin D plasma levels, and time before the surgical procedure;

b. logistic regression models showed that handgrip strength was directly associated with higher probability of walking recovery, both at any follow-up (incident walking recovery), and for at least 2 consecutive follow-ups (persistent walking recovery);

b. Kaplan-Meier survival estimates showed that lower grip strength was related to increased mortality after hip surgery;

c. the association between grip performance and walking recovery was clinically relevant and statistically independent of potential confounders.
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Hip Fracture Risk and Link to Obesity Gene

Professor Tuan V. Nguyen Osteoporosis and Bone Biology Program Garvan Institute of Medical Research 384 Victoria Street, Darlinghurst NSW 2010 AustraliaMedicalResearch.com Interview with:
Professor Tuan V. Nguyen
Osteoporosis and Bone Biology Program
Garvan Institute of Medical Research
384 Victoria Street, Darlinghurst NSW 2010
Australia


MedicalResearch.com: What are the main findings of the study?

Dr. Nguyen: We analyzed polymorphisms of the FTO (fat mass and obesity) gene in 934 elderly women of Caucasian background, and found that carriers of minor genotype (AA) of the SNP rs1121980 had a two-fold increase in the risk of hip fracture compared with carriers of major genotype (GG). Approximately 20% of women are carriers of the AA genotype. We estimate that about 17% of hip fracture cases could be attributed to the variation within the gene.
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