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Traumatic brain injury ups mortality in seniors with hip fractures

05 Dec 2018
Elderly patients with hip fractures better treated at smaller health facilities.

Traumatic brain injuries (TBI) appear to increase the risk of mortality among elderly adults with hip fractures, according to a recent study.

In the study sample of 38,230 participants with hip fracture (aged 65 years), 2.7 percent (n=1,043; mean age 84.4±7.4 years; 77.7 percent female) had TBI while the remaining 97.3 percent (n=37,187; mean age 83.7±7.6 years; 78.0 percent female) did not. There were significantly more deaths in the former group (53.4 percent vs 45.8 percent; p<0.001).

Specifically, in the year following the hip fracture incident, those with TBI demonstrated a mortality rate of 49 per 100 person-years, which was higher than that in participants without TBI (34 per 100 person-years). Respective 5-year cumulative mortality rates were 36 and 26 per 100 person-years.

The risk of mortality attributable to TBI was 15 deaths per 100 person-years.

Cox proportional hazards models adjusted for Alzheimer’s disease, related dementias, atrial fibrillation depression, stroke, ischaemic heart disease, coagulation disorder and hypertension further validated these findings. Regardless of sex, TBI remained significantly associated with an elevated risk of mortality (hazard ratio, 1.24; 95 percent CI, 1.14–1.35).

The limitations of the present study included the lack of knowledge about the mechanism of hip injury and about the severity, type and location of the TBI. Participants’ status in terms of delirium and cognitive impairment was likewise not taken into consideration.

Despite these limitations, researchers said that clinicians and practitioners should still screen for TBI in vulnerable elderly adults.

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