Survival among elderly patients after fractures of the distal radius.
Studies have documented increased mortality rates in patients sustaining hip and vertebral fractures. Distal radius fractures are common injuries among the elderly and are a significant source of disability. This study analyzed survival rates in an elderly patient cohort after distal radius fractures and determined mortality risk factors. In addition, the mortality rates in our patient cohort were compared with those of the general population of the United States matched for age and gender. The records of 325 elderly patients (250 women, 65 men) treated for distal radius fractures between 1992 and 1999 were reviewed and submitted to the national death registry maintained by the National Death Index and the Center for Disease Control and Prevention. The mortality experience of the patient cohort was analyzed by using bivariate statistical tests and multivariate regression. Average age at diagnosis was 77.4 years (range, 65-106 y). A total of 21% of patients (29% of men, 19% of women) died during the study period. After accounting for variations in age, total number of comorbidities, and Charlson comorbidity index, men were 2.65 times more likely to die than women (95% CI, range, 1.31-5.36) and their hazard of death was 1.83 times that of women (95% CI, range, 1.07-3.14). After accounting for variations in age and gender, patients with comorbidities were 5.23 times more likely to die (95% CI, range, 1.80-15.23) and did not survive as long as those without comorbidities. At 7 years after radius fracture, the cumulative estimated survival in the cohort under study was 57% compared with an expected value of 71% for the US population. Survival rates after distal radius fractures were notably lower than those expected for individuals of the same age and gender in standard populations. Men were twice as likely to die as women and did so almost twice as quickly.
Rozental
Tamara D
TD
Division of Hand Surgery, Hospital of the University of Pennsylvania, Philadelphia, USA.
Branas
Charles C
CC
Bozentka
David J
DJ
Beredjiklian
Pedro K
PK
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016016:Proportional Hazards Models; D011885:Radius Fractures / Q000401:mortality*; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States / Q000453:epidemiology