アブストラクト | INTRODUCTION: The risk of postoperative sequelae and in-hospital mortality in Japanese patients aged 90 years and older with hip fractures is unexplored. This study aims to use a comprehensive medical claims database in Japan to compare super-elderly patients aged 90 years and older with elderly aged 65-89 and clarify the risk of sequelae and in-hospital mortality in super-elderly patients. MATERIALS AND METHODS: We retrospectively analyzed the Diagnosis Procedure Combination (DPC) database for all of Japan from April 2016 to March 2022. Medical records from approximately 1100 DPC-related hospitals were provided with consistent consent during this period. In this study, we focused on super-elderly patients and examined the association with the risk of postoperative pneumonia, pulmonary embolism, myocardial infarction, urinary tract infection, acute renal dysfunction, subsequent cognitive dysfunction, and in-hospital mortality after one-to-one propensity score matching. RESULTS: After performing propensity score matching based on sex and comorbidities, 129,953 pairs of patients were identified. These pairs were compared to elderly and super-elderly patients. The results of this study showed that compared with hip fractures in the elderly, hip fractures in the super-elderly were associated with an increased risk of pneumonia, urinary tract infection, acute renal dysfunction, subsequent cognitive dysfunction, and in-hospital mortality after adjustment for confounders. The odds ratio of in-hospital mortality was 2.190 (95% CI 2.062-2.325). CONCLUSION: As it has been shown that super-elderly patients with hip fractures are at greater risk of respiratory and urinary tract infections and increased in-hospital mortality, careful attention should be required for perioperative management. |
ジャーナル名 | Journal of bone and mineral metabolism |
Pubmed追加日 | 2024/11/13 |
投稿者 | Mori, Yu; Tarasawa, Kunio; Tanaka, Hidetatsu; Mori, Naoko; Fushimi, Kiyohide; Aizawa, Toshimi; Fujimori, Kenji |
組織名 | Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine,;1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.;yu-mori@med.tohoku.ac.jp.;Department of Health Administration and Policy, Tohoku University Graduate School;of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.;Department of Radiology, Akita University Graduate School of Medicine, 1-1-1;Hondo, Akita, Akita, 010-8543, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku,;Tokyo, 113-8519, Japan. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39510991/ |