Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study
Objectives: Hip fractures mostly require surgical treatment and are associated with increased health-care costs and mortality rates. Patients with cirrhosis have low bone marrow density and inferior immune status which contribute to a higher fracture rate and higher surgical complication rate. This...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-08-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/2309499020918032 |
| _version_ | 1818408164337385472 |
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| author | Chih-Hsiang Chang Chee-Jen Chang Yi-Chun Wang Chih-Chien Hu Yuhan Chang Pang-Hsin Hsieh Dave W Chen |
| author_facet | Chih-Hsiang Chang Chee-Jen Chang Yi-Chun Wang Chih-Chien Hu Yuhan Chang Pang-Hsin Hsieh Dave W Chen |
| author_sort | Chih-Hsiang Chang |
| collection | DOAJ |
| description | Objectives: Hip fractures mostly require surgical treatment and are associated with increased health-care costs and mortality rates. Patients with cirrhosis have low bone marrow density and inferior immune status which contribute to a higher fracture rate and higher surgical complication rate. This population-based study evaluated the prevalence, complication, and mortality rates due to hip fractures in cirrhotic patients. Methods: Taiwan National Health Insurance Research Database data were used. The study group included 117,129 patients with hip fractures diagnosed from 2004 to 2010, including 4048 patients with cirrhosis. The overall prevalence, morbidity, and mortality rates of the cirrhosis group with hip fractures were compared with the rates of a general group with hip fractures. Results: The cirrhosis group patients were younger than the general group patients (71.2 vs. 73.96 years, p < 0.001). The annual incidence of hip fractures in the cirrhosis and general groups was 46–54 and 7–7.5 per 10,000 person-years, respectively, with an incidence rate ratio of 6.95 (95% confidence interval 6.74–7.18). The rates of infection, urinary tract infection, and peptic ulcer disease were higher in the cirrhosis group (3.46% vs. 1.91%, 9.56% vs. 9.11%, and 8.05% vs. 3.55%, respectively; all p < 0.001). The mortality rate after hip fracture was also higher in the cirrhosis group than in the general group (within 3 months: 8.76–12.64% vs. 4.96–5.30% and within 1 year: 29.72–37.99% vs. 12.84–14.57%). Conclusion : Cirrhotic patients with hip fractures were relatively younger; had a seven times higher annual hip fracture incidence; had higher complication rates of infection, urinary tract infection, and peptic ulcer disease; and had two to three times higher a mortality rate at 3 months and 1 year. Clinicians should pay particular attention to the possibility of osteoporosis and hip fractures in patients with liver cirrhosis. Level of Evidence: Level III, case–control study |
| first_indexed | 2024-12-14T09:39:23Z |
| format | Article |
| id | doaj.art-040e6725f0a04f91aef9d8feec7661a7 |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-14T09:39:23Z |
| publishDate | 2020-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-040e6725f0a04f91aef9d8feec7661a72022-12-21T23:07:49ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902020-08-012810.1177/2309499020918032Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based studyChih-Hsiang Chang0Chee-Jen Chang1Yi-Chun Wang2Chih-Chien Hu3Yuhan Chang4Pang-Hsin Hsieh5Dave W Chen6 Graduate Institute of Clinical Medical Sciences, College of Medicine, , Taoyuan, Taiwan Clinical Informatics and Medical Statistics Research Center, , Tao-Yuan, Taiwan Research Services Center for Health Information, , Tao-Yuan, Taiwan College of Medicine, , Taoyuan, Taiwan College of Medicine, , Taoyuan, Taiwan College of Medicine, , Taoyuan, Taiwan Department of Orthopedic Surgery, , Keelung, TaiwanObjectives: Hip fractures mostly require surgical treatment and are associated with increased health-care costs and mortality rates. Patients with cirrhosis have low bone marrow density and inferior immune status which contribute to a higher fracture rate and higher surgical complication rate. This population-based study evaluated the prevalence, complication, and mortality rates due to hip fractures in cirrhotic patients. Methods: Taiwan National Health Insurance Research Database data were used. The study group included 117,129 patients with hip fractures diagnosed from 2004 to 2010, including 4048 patients with cirrhosis. The overall prevalence, morbidity, and mortality rates of the cirrhosis group with hip fractures were compared with the rates of a general group with hip fractures. Results: The cirrhosis group patients were younger than the general group patients (71.2 vs. 73.96 years, p < 0.001). The annual incidence of hip fractures in the cirrhosis and general groups was 46–54 and 7–7.5 per 10,000 person-years, respectively, with an incidence rate ratio of 6.95 (95% confidence interval 6.74–7.18). The rates of infection, urinary tract infection, and peptic ulcer disease were higher in the cirrhosis group (3.46% vs. 1.91%, 9.56% vs. 9.11%, and 8.05% vs. 3.55%, respectively; all p < 0.001). The mortality rate after hip fracture was also higher in the cirrhosis group than in the general group (within 3 months: 8.76–12.64% vs. 4.96–5.30% and within 1 year: 29.72–37.99% vs. 12.84–14.57%). Conclusion : Cirrhotic patients with hip fractures were relatively younger; had a seven times higher annual hip fracture incidence; had higher complication rates of infection, urinary tract infection, and peptic ulcer disease; and had two to three times higher a mortality rate at 3 months and 1 year. Clinicians should pay particular attention to the possibility of osteoporosis and hip fractures in patients with liver cirrhosis. Level of Evidence: Level III, case–control studyhttps://doi.org/10.1177/2309499020918032 |
| spellingShingle | Chih-Hsiang Chang Chee-Jen Chang Yi-Chun Wang Chih-Chien Hu Yuhan Chang Pang-Hsin Hsieh Dave W Chen Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study Journal of Orthopaedic Surgery |
| title | Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study |
| title_full | Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study |
| title_fullStr | Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study |
| title_full_unstemmed | Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study |
| title_short | Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study |
| title_sort | increased incidence morbidity and mortality in cirrhotic patients with hip fractures a nationwide population based study |
| url | https://doi.org/10.1177/2309499020918032 |
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