(Press-News.org) Patients undergoing surgery for a hip fracture were older and had more medical conditions than patients who underwent an elective total hip replacement, factors that may contribute to the higher risk of in-hospital death and major postoperative complications experienced by hip fracture surgery patients, according to a study in the September 15 issue of JAMA.
Although hip surgery can improve mobility and pain, it can be associated with major postoperative medical complications and mortality. Patients undergoing surgery for a hip fracture are at substantially higher risk of mortality and medical complications compared with patients undergoing an elective total hip replacement (THR). The effect of older age and other medical conditions associated with hip fracture on this increased risk has not been known, according to background information in the article.
Yannick Le Manach, M.D., Ph.D., of McMaster University, Hamilton, Ontario, Canada and colleagues examined if there was a difference in hospital mortality among patients who underwent hip fracture surgery relative to an elective THR, after adjustment for age, sex, and preoperative medical conditions. Using the French National Hospital Discharge Database, the researchers included patients older than 45 years who underwent hip surgery at French hospitals from January 2010 to December 2013. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, codes were used to determine patients' co-existing conditions and complications after surgery.
A total of 690,995 eligible patients were included from 864 centers in France. Patients undergoing elective THR surgery (n = 371,191) were younger, more commonly men, and had less medical comorbidity compared with patients undergoing hip fracture surgery. Following hip fracture surgery (n = 319,804), 10,931 patients (3.4 percent) died before hospital discharge and 669 patients (0.18 percent) died after elective THR.
Analysis of the matched populations (n = 234,314) demonstrated a higher risk of mortality (1.8 percent for hip fracture surgery vs 0.3 percent for elective THR) and of major postoperative complications (5.9 percent for hip fracture surgery vs 2.3 percent for elective THR) among patients undergoing hip fracture surgery.
"Patients undergoing surgery for a hip fracture were older and had more comorbidities than patients who underwent an elective THR, and these differences accounted for some of the difference in outcomes between these groups," the authors write.
"If the absolute risk increases of 1.51 percent for in-hospital mortality and 3.54 percent for major postoperative complications were modifiable, they would be consistent with the number needed to treat of 59 patients for in-hospital mortality and 28 patients for major postoperative complications. Hip fracture may be associated with physiologic processes that are not present in circumstances leading to elective THR and increase the risk of morbidity and mortality following surgery."
"Further studies are needed to define the causes for these differences."
INFORMATION:
(doi:10.1001/jama.2015.10842; Available pre-embargo to the media at http:/media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Women physicians are substantially less likely to be full professors than men of similar age, experience, specialty and research productivity.
With recent increases in the number of women attending medical school, women now comprise nearly half of all new physicians. But the proportion of women at the rank of fullprofessor at U.S. medical schools has not changed since 1980, despite efforts to increase equity, according to a new research study led by Anupam Jena, associate professor of health care policy at Harvard Medical School. The results are published today in JAMA.
"Many ...
A group of scientists from ITMO University, Australian National University and Aalto University called into question the results of a study, published by the researchers from Cambridge University in a prestigious scientific journal Physical Review Letters. In the original study, the British scientists claimed that they managed to find the missing link in the electromagnetic theory. The findings, according to the scientists, could help decrease the size of antennas in electronic devices manifold, promising a major breakthrough in the field of wireless communications.
The ...
Drugs commonly used to treat high blood pressure, and prevent heart attacks and strokes, are associated with significantly worse cardiovascular outcomes in hypertensive African Americans compared to whites, according to a new comparative effectiveness research study led by researchers in the Department of Population Health at NYU Langone Medical Center.
The study, published on September 15 in the Journal of the American College of Cardiology (JACC), is unique, the authors say, in that it evaluates racial differences in cardiovascular outcomes and mortality between hypertensive ...
Are climate predictions over periods of several years reliable if weather forecast are still only possible for short periods of several days? Nevertheless there are options to predict the development of key parameters on such long time scales. A new study led by scientists at GEOMAR Helmholtz Centre for Ocean Research Kiel shows how the well-known 11-year cycle of solar activity affects the long-time development of dominant large-scale pressure systems in the Northern Hemisphere.
For their investigations the scientists used a coupled ocean-atmosphere model. In addition, ...
September 15, 2015 - Nyon, Switzerland A study from the University of Southampton and Sheffield Medical School in the UK projects a dramatic increase in the burden of fragility fractures within the next three decades. By 2040, approximately 319 million people will be at high risk of fracture -double the numbers considered at high risk today.
In this first study to estimate the global burden of disease in terms of fracture probability, the researchers quantified the number of individuals worldwide aged 50 years or more at high risk of fracture in 2010 and projected figures ...
Marijuana use among American high school students is significantly lower today than it was 15 years ago, despite the legalization in many states of marijuana for medical purposes, a move toward decriminalization of the drug and the approval of its recreational use in a handful of places, new research suggests.
The Johns Hopkins Bloomberg School of Public Health researchers say, however, that marijuana use is significantly greater than the use of other illegal drugs, with 40 percent of teens in 2013 saying they had ever smoked marijuana. That number was down from 47 percent ...
The twentieth tropical depression of the Northwestern Pacific Ocean formed early on September 14 and became a tropical storm the next day, triggering a tropical storm watch. NASA's Aqua satellite passed over the low pressure area as it was consolidating and saw powerful thunderstorms circling the center.
The Atmospheric Infrared Sounder or AIRS instrument that flies aboard NASA's Aqua satellite gathers data in infrared light that provides information about temperatures. The colder the cloud top temperature, the higher the storms are in the troposphere (because the higher ...
TORONTO, Sept. 15, 2015 - A commonly prescribed drug for heart disease may do more good than previously thought. Researchers at York University have found that beta-blockers may prevent further cell death following a heart attack and that could lead to better longer term patient outcomes.
Human hearts are unable to regenerate. When cardiac muscle cells die during and immediately after a heart attack, there is no way to bring the organ back to full health, which contributes to the progression towards eventual heart failure.
Preventing the cells from dying in the first ...
Millions of years ago, our primate ancestors turned from trees and shrubs to search for food on the ground. In human evolution, that has made all the difference.
The shift toward a grass-based diet marked a significant step toward the diverse eating habits that became a key human characteristic, and would have made these early humans more mobile and adaptable to their environment.
New evidence just published by a research team led by a Johns Hopkins University scientist shows that this significant shift took place about 400,000 years earlier than experts previously ...
Washington, DC - September 15, 2015 - For years, researchers have known that the human skin is home to a diverse community of microorganisms, collectively known as the skin microbiome. Now a new study has shown that individuals with a particular skin microbiome can effectively clear bacteria that cause chancroid, a sexually transmitted disease common in the developing world that has been linked to enhanced HIV transmission. The study, published in the September 15th issue of mBio, is the first prospective study to show that the skin microbiome can influence the outcomes ...
