TY - JOUR
T1 - Associations between presence of diabetes, mortality and fracture type in individuals with a hip fracture
AU - Spaetgens, Bart
AU - Brouns, Steffie H. A.
AU - Linkens, Aimée E. M. J. H.
AU - Poeze, Martijn
AU - ten Broeke, René H. M.
AU - Brüggemann, Renée A. G.
AU - Sipers, Walther
AU - Henry, Ronald M. A.
AU - Hanssen, Nordin M. J.
N1 - Funding Information: NMJH is supported by a Senior Clinical Dekker grant by the Dutch Heart Foundation (grant number 2021T055 ) and a DFN- DON grant 2020 (Grant number 2020.10.002). Publisher Copyright: © 2022 The Author(s)
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Aims: An overlooked aspect of diabetes is an increased risk of hip fractures, with associated mortality. We investigated whether fracture type and/or burden of comorbidities explains the increased risk of mortality in diabetes after hip fracture. Methods: For this cohort study, we used a de-identified data set of hip fracture patients registered in a quality-of-care registry (2017/2018) included in Maastricht University Medical Centre. Results: Among 594 hip fracture patients, 90 (15.2 %) had diabetes. Median (IQR) age was 82 (71–87) years and 63.8 % were women. Compared to patients without, patients with diabetes had higher median Charlson Comorbidity Index [1 (0–2) vs 0 (0–2), P < 0.001)] and were more likely to sustain intertrochanteric/subtrochanteric fractures [54.4 vs 38.7 %, P = 0.02]. Over a median follow-up of 2.7 (1.6–3.3) years, crude mortality rate was 30.8 % in patients without and 50.0 % in patients with diabetes. This association remained unaltered after adjustment for age, sex, BMI, fracture type or burden of co-morbidities. Conclusion: Individuals with diabetes display a greatly increased absolute mortality risk after hip fracture. This association was not attenuated after adjustment for fracture type or non-diabetes associated co-morbidity. These findings have important implications for diabetes care in hip fracture patients, and underline the importance of fracture prevention.
AB - Aims: An overlooked aspect of diabetes is an increased risk of hip fractures, with associated mortality. We investigated whether fracture type and/or burden of comorbidities explains the increased risk of mortality in diabetes after hip fracture. Methods: For this cohort study, we used a de-identified data set of hip fracture patients registered in a quality-of-care registry (2017/2018) included in Maastricht University Medical Centre. Results: Among 594 hip fracture patients, 90 (15.2 %) had diabetes. Median (IQR) age was 82 (71–87) years and 63.8 % were women. Compared to patients without, patients with diabetes had higher median Charlson Comorbidity Index [1 (0–2) vs 0 (0–2), P < 0.001)] and were more likely to sustain intertrochanteric/subtrochanteric fractures [54.4 vs 38.7 %, P = 0.02]. Over a median follow-up of 2.7 (1.6–3.3) years, crude mortality rate was 30.8 % in patients without and 50.0 % in patients with diabetes. This association remained unaltered after adjustment for age, sex, BMI, fracture type or burden of co-morbidities. Conclusion: Individuals with diabetes display a greatly increased absolute mortality risk after hip fracture. This association was not attenuated after adjustment for fracture type or non-diabetes associated co-morbidity. These findings have important implications for diabetes care in hip fracture patients, and underline the importance of fracture prevention.
KW - Diabetes
KW - Hip fractures
KW - In-hospital complications
KW - Older individuals
UR - http://www.scopus.com/inward/record.url?scp=85138584585&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.diabres.2022.110084
DO - https://doi.org/10.1016/j.diabres.2022.110084
M3 - Article
C2 - 36122868
SN - 0168-8227
VL - 192
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 110084
ER -