title: Advanced Age, High β-CTX Levels, and Impaired Renal Function are Independent Risk Factors for All-Cause One-Year Mortality in Hip Fracture Patients.
abstract: Risk factors for increased mortality in hip fracture patients include older age, male sex, fracture type, bone mineral density, and pre-existing co-morbidities. The role of biochemical and other anthropometric parameters on hip fracture mortality remains unclear. The aim of this study was to identify the risk factors for one-year mortality in patients with hip fractures. A total of 236 consecutive patients (59 males) with hip fractures were followed over a one-year period. Patient age, gender, type of fracture, type of treatment, time from admission to surgery, type of anesthesia, body mass index, and electrocardiograms were recorded. Complete blood counts, serum electrolytes, urea, creatinine, d-dimers, calcium, phosphate, osteocalcin, and beta-isomerised C-terminal telopeptide of collagen type I (β-CTX) were measured at admission and estimated glomerular filtration rate (eGFR) was calculated. Multivariate Cox regression models were used to analyze the association of these parameters with survival. One-year mortality rate was 28.4%. Age was independently associated with mortality (HR 1.117, 95% CI 1.062-1.174, P < 0.001). In a multivariable model, mortality was increased in patients with higher β-CTX (HR 4.63 95% CI 1.87-11.45, P = 0.001) and lower eGFR (HR 0.972, 95% CI 0.956-0.987, P < 0.001). Patients younger than 84 years, with eGFR < 55.4 ml/min had ten times higher mortality rates (3.2 vs. 24.5%, HR 9.73, 95% CI 2.06-45.93) as well as those with β-CTX > 0.276 g/L (3.5 vs. 25.7%, HR 9.5, 95% CI 2.11-42.76). Advanced age, high β-CTX levels, and impaired renal function are independent risk factors of mortality in patients with hip fractures.
authors.affiliation: Department of Nephrology and Dialysis, University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, 10000, Zagreb, Croatia.
authors.forename: Tonko
authors.initials: T
authors.lastname: Gulin
authors.affiliation: Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, Vinogradska cesta 29, 10000, Zagreb, Croatia. ivkruljac@gmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Kruljac
authors.affiliation: Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, Vinogradska cesta 29, 10000, Zagreb, Croatia.
authors.forename: Lora
authors.initials: L
authors.lastname: Kirigin
authors.affiliation: Department of Pulmonology, Immunology and Rheumatology, University Hospital Center "Sestre Milosrdnice", 10000, Zagreb, Croatia.
authors.forename: Marcela
authors.initials: M
authors.lastname: Merc
authors.affiliation: Clinical Institute of Chemistry, University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, 10000, Zagreb, Croatia.
authors.forename: Marina
authors.initials: M
authors.lastname: Pavić
authors.affiliation: Tissue Bank, University Hospital Center "Sestre Milosrdnice", 10000, Zagreb, Croatia.
authors.forename: Mirna Tominac
authors.initials: MT
authors.lastname: Trcin
authors.affiliation: Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, 10000, Zagreb, Croatia.
authors.forename: Adrijana
authors.initials: A
authors.lastname: Bokulić
authors.affiliation: Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, 10000, Zagreb, Croatia.
authors.forename: Željka Bukovec
authors.initials: ŽB
authors.lastname: Megla
authors.affiliation: Department of Endocrinology, University Hospital Center Zagreb, University of Zagreb Medical School, 10000, Zagreb, Croatia.
authors.forename: Darko
authors.initials: D
authors.lastname: Kaštelan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood / Q000502:physiology*; D002423:Cause of Death; D024042:Collagen Type I / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006620:Hip Fractures / Q000097:blood / Q000150:complications / Q000401:mortality*; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D024042:Collagen Type I
keywords: Age; Hip fractures; One-year mortality; Renal function; Risk factors; eGFR; β-CTX