Is femoral artery calcification a sign of mortality in elderly hip fractures?

Is femoral artery calcification a sign of mortality in elderly hip fractures?

: It is important to determine the risks of mortality in elderly patients with hip fractures. The aim of this study wasto investigate the effect of femoral artery calcification on mortality risk in patients with cemented partial hip prosthesis.Methods: The study included 145 patients (≥65-years-old) with cemented partial hip prosthesis operated following hip fracture.Patients were divided into two groups: Group (1) included those without femoral artery calcification, and Group (2) with femoralartery calcifications observed on direct radiography. Age, gender, duration of hospitalization, time of death and follow-up duration, ASA score, anesthesia type, fracture type, complication and time of operation for patients were compared between twogroups.Results: After exclusion of certain patients due to lack of necessary information in their documents, a total of 116 patients wereinvestigated. The mean age of patients was 81.52±6.82. Mean follow-up duration was 35.39 (range: 0–76) months. Three outof 116 patients died after some complications during surgery. Mean time of death after surgery was 21.21 months in Group 1and 23.86 months in Group 2 (p=0.628).Conclusion: The results of this study showed that femoral artery calcification in patients with cemented prosthesis due tohip fracture at advanced age had no effect on mortality. However, there is a need for advanced studies with larger patientgroups.

___

  • 1. Abedin M, Tintut Y, Demer LL. Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol 2004;24: 1161–70.
  • 2. Kardos A, Casadei B. Hormone replacement therapy and ischaemic heart disease among postmenopausal women. J Cardiovasc Risk 1999;6:105–12.
  • 3. Cannata-Andia JB, Rodriguez-Garcia M, Carrillo-Lopez N, NavesDiaz M, Diaz-Lopez B. Vascular calcifications: pathogenesis, management, and impact on clinical outcomes. J Am Soc Nephrol 2006; 17:S267–73.
  • 4. Abrahamsen B, Van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 2009;20:1633–50.
  • 5. Negrete-Corona J, Alvarado-Soriano JC, Reyes-Santiago LA. Hip fracture as risk factor for mortality in patients over 65 years of age. Case-control study. [Article in Spanish] Acta Ortop Mex 2014;28: 352–62.
  • 6. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop 2011;45:15–22.
  • 7. Uluda¤ Ö, Tutak A, Güler A, Do¤ukan M, Kaya R, Duran M. Retrospective evaluation of the effects of albumin and hemoglobin values on the duration of hospital stay and mortality in elderly patients operated for hip fracture. [Article in Turkish] Ad›yaman Üniversitesi Sa¤l›k Bilimleri Dergisi 2018;4:637–47.
  • 8. Chan KC, Gill GS. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures. Clin Orthop Relat Res 2000;(371): 206–15.
  • 9. Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V. Aortic calcification and the risk of osteoporosis and fractures. J Clin Endocrinol Metab 2004;89:4246–53.
  • 10. London GM, Marchais SJ, Guérin AP, Boutouyrie P, Métivier F, de Vernejoul MC. Association of bone activity, calcium load, aortic stiffness, and calcifications in ESRD. J Am Soc Nephrol 2008;19: 1827–35.
  • 11. Cannata-Andia JB, Roman-Garcia P, Hruska K. The connections between vascular calcification and bone health. Nephrol Dial Transplant 2011;26:3429–36.
  • 12. El Maghraoui A, Rezqi A, Mounach A, Achemlal L, Bezza A, Ghozlani I. Relationship between vertebral fracture prevalence and abdominal aortic calcification in men. Rheumatology (Oxford) 2012; 51:1714–20.
  • 13. Naves M, Rodríguez-García M, Díaz-López JB, Gómez-Alonso C, Cannata-Andía JB. Progression of vascular calcifications is associated with greater bone loss and increased bone fractures. Osteoporos Int 2000;19:1161–6.
  • 14. Bagger YZ, Tankó LB, Alexandersen P, Qin G, Christiansen C. Radiographic measure of aorta calcification is a site-specific predictor of bone loss and fracture risk at the hip. J Intern Med 2006;259: 598–605.
  • 15. Adragao T, Herberth J, Monier-Faugere MC, Branscum AJ, Ferreira A, Frazao JM, Dias Curto J, Malluche HH. Low bone volume-a risk factor for coronary calcifications in hemodialysis patients. Clin J Am Soc Nephrol 2009;4:450–5.
  • 16. Coen G, Ballanti P, Mantella D, Manni M, Lippi B, Pierantozzi A, Di Giulio S, Pellegrino L, Romagnoli A, Simonetti G, Splendiani G. Bone turnover, osteopenia and vascular calcifications in hemodialysis patients: a histomorphometric and multislice CT study. Am J Nephrol 2009;29:145–52.
  • 17. Gölge UH, Pazarci O, Kilinç S, Nusran G, Kaymaz B, Göksel F, Kömürcü E, Bulut O. The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study. Acta Orthop Belg 2016;82:508–15.
  • 18. Parker MJ, Khan RJK, Crawford J, Pryor GA. Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly. A randomised trial of 455 patients. J Bone Joint Surg Br 2002; 84:1150–5.
  • 19. Braithwaite RS, Col NF, Wong JB. Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 2003;51:364–70.
  • 20. Johnell O, Kanis JA. An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 2004;15:897–902.
  • 21. Liu Y, Wang Z, Xiao W. Risk factors for mortality in elderly patients with hip fractures: a meta-analysis of 18 studies. Aging Clin Exp Res 2018;30:323–30.
  • 22. Moran CG, Wenn RT, Sikand M, Taylor AM. Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am 2005;87:483–9.