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@ARTICLE{Fink:278792,
author = {Fink, Anne and Falk, Steffi S I and Georges, Daniela},
title = {{C}omparing mortality in the elderly after proximal femur
fractures and coxarthrosis: the effect of individual health
characteristics and day of surgery.},
journal = {European journal of trauma and emergency surgery},
volume = {51},
number = {1},
issn = {1863-9933},
address = {Heidelberg},
publisher = {Springer Medizin},
reportid = {DZNE-2025-00628},
pages = {213},
year = {2025},
abstract = {This study investigates mortality variations between
elective and urgent hip surgeries, focusing surgery timing
and its impact on post-operative mortality. By comparing
cases of femoral neck fractures, pertrochanteric fractures,
and coxarthrosis across different follow-up durations, it
aims to identify factors contributing to increased
mortality.We used a random sample of German longitudinal
health claims data (N = 250,000, 2004-2019) and identified
10,310 patients aged 50 years and older who underwent
surgery for femoral neck fracture, pertrochanteric fracture,
or coxarthrosis between 2004 and 2014. We tracked mortality
at 30 days, 1 year, and 5 years. Cox proportional models
were used, adjusted for the following covariates at the time
of surgery: sex, age, comorbidities, nursing home
dependency, discharge diagnosis, and weekday of
surgery.Mortality probabilities were $5\%$ at 30 days,
$15.6\%$ at 1 year, and $38.9\%$ at 5 years, with
significantly higher risks for fractures than coxarthrosis.
Key factors influencing mortality included age,
comorbidities (e.g., heart failure, stroke, myocardial
infarction, dementia), and care dependency levels. Women had
lower risks than men across all periods. Short-term
mortality was most affected by comorbidities, while
long-term mortality correlated with chronic health
conditions such as nicotine abuse and diabetes mellitus, and
care needs. Surgery timing showed no consistent weekday
effects.Mortality differences reflect the impact of acute
trauma from emergency surgery rather than the surgical
procedure itself, emphasizing the need for optimized
planning, preparation, early treatment and adaptable care
structures in an aging population.},
keywords = {Humans / Female / Male / Aged / Germany: epidemiology /
Middle Aged / Aged, 80 and over / Hip Fractures: surgery /
Hip Fractures: mortality / Femoral Neck Fractures: surgery /
Femoral Neck Fractures: mortality / Osteoarthritis, Hip:
surgery / Osteoarthritis, Hip: mortality / Comorbidity /
Risk Factors / Time Factors / Longitudinal Studies / Age
Factors / Elective Surgical Procedures: mortality / Proximal
Femoral Fractures / Cox proportional models (Other) /
Coxarthrosis (Other) / Geriatric (Other) / Mortality (Other)
/ Proximal femur fracture (Other) / Surgery (Other)},
cin = {AG Doblhammer},
cid = {I:(DE-2719)1012002},
pnm = {354 - Disease Prevention and Healthy Aging (POF4-354)},
pid = {G:(DE-HGF)POF4-354},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40392330},
doi = {10.1007/s00068-025-02882-y},
url = {https://pub.dzne.de/record/278792},
}