Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients
Wenqing Tian, Jueli Wu, Tao Tong, Lu Zhang, Aiguo Zhou, Ning Hu, Wei Huang, Bo Zhou
Abstract
Objective . To explore the effect of diabetes on short-term (30 days after fracture) and 1-year outcomes for fragility hip fracture patients. Methods . We conducted a retrospective cohort study involving 161 diabetic hip fracture patients (older than 60 years) and 483 nondiabetic hip fracture patients. Patients were followed up on day 30 and 1 year after fracture. The short-term outcome was complications that occurred within 30 days after hip fracture and length of stay. The 1-year outcomes were postfracture functional outcomes and reduced activity level and mortality rate within 1 year after fracture. The clinical characteristics and outcomes of patients were analyzed. Results . Compared with nondiabetic patients, diabetic patients had a longer length of awaiting surgery (6.0 vs. 5.0 days, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.031</mml:mn></mml:mrow></mml:math>) and a longer length of total hospital stay (17 vs. 15 days, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>). Furthermore, compared with nondiabetic patients, diabetic patients have higher costs (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.011</mml:mn></mml:mrow></mml:math>), in addition to being more prone to developing urinary tract infections (6.2% vs. 1.7%, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.002</mml:mn></mml:mrow></mml:math>) and deep vein thrombosis (4.3% vs. 1.4%, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.029</mml:mn></mml:mrow></mml:math>) complications. However, at one-year follow-up, no differences in recovery of function and mortality were observed between the two groups. Conclusions . Diabetic patients are at an increased risk of urinary tract infections and deep vein thrombosis complications but have similar recovery of function and 1-year mortality compared to nondiabetic patients.