title: Impact of diabetes on inpatient mortality and length of stay for elderly patients presenting with fracture of the proximal femur.
abstract: BACKGROUND
  Osteoporosis-related fractures of the proximal femur cause significant morbidity and result in an economic burden on societies. It remains debatable whether diabetic patients with proximal fracture of the femur demonstrate poorer outcomes in terms of hospital stay and mortality compared to non-diabetic controls.
  
  
  METHODS
  All patients over 65years old admitted to the University Hospital Birmingham during 2007-2010 with a diagnosis of a fracture of the proximal femur (total 1468 including 197 patients with diabetes) were analysed. Eligibility and case definitions were ascertained using electronic records. Multivariate analyses were conducted to control for the confounding effect of covariates, which may be associated with the outcomes of interest on the basis of biological plausibility and known risks.
  
  
  RESULTS
  In-patient mortality was estimated at 14.2% and 12% for the diabetic and non-diabetic patients respectively. Diabetes was not found to be a significant predictor of in-patient mortality, before and after adjustment for the covariates [Adjusted odds ratio 1.01 (95% CI 0.62-1.65)], in contrast to advancing age, male gender, co-morbidity score, low albumin and high creatinine concentrations. Similarly, median length of stay was greater in the diabetes patients, yet only by a day (20 versus 19 days). This was not statistically significant in either the unadjusted (p=0.17) or in the multivariate analysis (p=0.06).
  
  
  CONCLUSIONS
  Diabetic patients admitted with fracture of the proximal femur did not demonstrate significantly poorer outcomes in terms of in-patient mortality and length of stay compared to non-diabetic patients.
authors: Public Health, Epidemiology and Biostatistics, University of Birmingham, UK. k.nirantharan@bham.ac.uk
authors: K
authors: K
authors: Nirantharakumar
authors: K A
authors: KA
authors: Toulis
authors: H
authors: H
authors: Wijesinghe
authors: M S
authors: MS
authors: Mastan
authors: M
authors: M
authors: Srikantharajah
authors: S
authors: S
authors: Bhatta
authors: T
authors: T
authors: Marshall
authors: J J
authors: JJ
authors: Coleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D048909:Diabetes Complications / Q000453:epidemiology / Q000628:therapy*; D057286:Electronic Health Records; D004739:England / Q000453:epidemiology; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D058866:Osteoporotic Fractures / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors