Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study
Abstract Introduction Addressing femoral neck fractures resulting from ground‐level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (intern...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Aging Medicine |
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| Online Access: | https://doi.org/10.1002/agm2.12279 |
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| author | Yijiong Yang Stacy A. Drake Jing Wang Gordon C. Shen Hongyu Miao Robert O. Morgan Xianglin L. Du David R. Lairson |
| author_facet | Yijiong Yang Stacy A. Drake Jing Wang Gordon C. Shen Hongyu Miao Robert O. Morgan Xianglin L. Du David R. Lairson |
| author_sort | Yijiong Yang |
| collection | DOAJ |
| description | Abstract Introduction Addressing femoral neck fractures resulting from ground‐level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (internal fixation or arthroplasty) vs nonoperative treatment for femoral neck fractures in older persons with AD. Methods This retrospective cohort study compared the mortality, hazard ratio, and survival rate between operative and nonoperative treatments, controlling for patients' demographic information and baseline health status. The study population consisted of Optum beneficiaries diagnosed with AD who experienced an initial femoral neck fracture claim between January 1, 2012, and December 31, 2017. Kaplan–Meier survival curves were applied to compare the treatment groups' post‐fracture survival rates and mortality. Cox regression was used to examine the survival period by controlling the covariates. Results Out of the 4157 patients with AD with femoral neck fractures, 59.8% were women (n = 2487). The median age was 81 years. The 1‐year survival rate for nonoperative treatment (70.19%) was lower than that for internal fixation (75.27%) and arthroplasty treatment (82.32%). Compared with the nonoperative group, arthroplasty surgical treatment had significant lower hazard risk of death (arthroplasty hazard ratio: 0.850, 95% CI: 0.728–0.991, P < 0.05). Discussion The findings suggest that the operative treatment group experiences higher survival rates and lower mortality rates than the nonoperative group. This paper provides insights into treatment outcomes of older adults with AD receiving medical care for femoral neck fractures. |
| first_indexed | 2024-04-24T15:12:07Z |
| format | Article |
| id | doaj.art-c782beb3a186422e86c05b1c44ae58f8 |
| institution | Directory Open Access Journal |
| issn | 2475-0360 |
| language | English |
| last_indexed | 2024-04-24T15:12:07Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Aging Medicine |
| spelling | doaj.art-c782beb3a186422e86c05b1c44ae58f82024-04-02T10:45:52ZengWileyAging Medicine2475-03602024-02-0171525910.1002/agm2.12279Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort studyYijiong Yang0Stacy A. Drake1Jing Wang2Gordon C. Shen3Hongyu Miao4Robert O. Morgan5Xianglin L. Du6David R. Lairson7College of Nursing Florida State University Tallahassee Florida USASchool of Nursing Bowling Green State University Bowling Green Ohio USACollege of Nursing Florida State University Tallahassee Florida USADepartment of Management, Policy and Community Health, School of Public Health The University of Texas Health Science Center at Houston Houston Texas USACollege of Nursing Florida State University Tallahassee Florida USADepartment of Management, Policy and Community Health, School of Public Health The University of Texas Health Science Center at Houston Houston Texas USADepartment of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health The University of Texas Health Science Center at Houston Houston Texas USADepartment of Management, Policy and Community Health, School of Public Health The University of Texas Health Science Center at Houston Houston Texas USAAbstract Introduction Addressing femoral neck fractures resulting from ground‐level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (internal fixation or arthroplasty) vs nonoperative treatment for femoral neck fractures in older persons with AD. Methods This retrospective cohort study compared the mortality, hazard ratio, and survival rate between operative and nonoperative treatments, controlling for patients' demographic information and baseline health status. The study population consisted of Optum beneficiaries diagnosed with AD who experienced an initial femoral neck fracture claim between January 1, 2012, and December 31, 2017. Kaplan–Meier survival curves were applied to compare the treatment groups' post‐fracture survival rates and mortality. Cox regression was used to examine the survival period by controlling the covariates. Results Out of the 4157 patients with AD with femoral neck fractures, 59.8% were women (n = 2487). The median age was 81 years. The 1‐year survival rate for nonoperative treatment (70.19%) was lower than that for internal fixation (75.27%) and arthroplasty treatment (82.32%). Compared with the nonoperative group, arthroplasty surgical treatment had significant lower hazard risk of death (arthroplasty hazard ratio: 0.850, 95% CI: 0.728–0.991, P < 0.05). Discussion The findings suggest that the operative treatment group experiences higher survival rates and lower mortality rates than the nonoperative group. This paper provides insights into treatment outcomes of older adults with AD receiving medical care for femoral neck fractures.https://doi.org/10.1002/agm2.12279Alzheimer's disease and Alzheimer's disease related dementiasarthroplastyfemoral neck fractureinternal fixationnon‐operative treatment |
| spellingShingle | Yijiong Yang Stacy A. Drake Jing Wang Gordon C. Shen Hongyu Miao Robert O. Morgan Xianglin L. Du David R. Lairson Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study Aging Medicine Alzheimer's disease and Alzheimer's disease related dementias arthroplasty femoral neck fracture internal fixation non‐operative treatment |
| title | Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study |
| title_full | Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study |
| title_fullStr | Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study |
| title_full_unstemmed | Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study |
| title_short | Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study |
| title_sort | comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among alzheimer s disease patients a retrospective cohort study |
| topic | Alzheimer's disease and Alzheimer's disease related dementias arthroplasty femoral neck fracture internal fixation non‐operative treatment |
| url | https://doi.org/10.1002/agm2.12279 |
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