Limits...
Mortality associated with bone fractures in COPD patients

View Article: PubMed Central - PubMed

ABSTRACT

Background and objective: COPD is well known to frequently coexist with osteoporosis. Bone fractures often occur and may affect mortality in COPD patients. However, in-hospital mortality related to bone fractures in COPD patients has been poorly studied. This retrospective study investigated in-hospital mortality of COPD patients with bone fractures using a national inpatient database in Japan.

Methods: Data of COPD patients admitted with bone fractures, including hip, vertebra, shoulder, and forearm fractures to 1,165 hospitals in Japan between July 2010 and March 2013, were extracted from the Diagnosis Procedure Combination database. The clinical characteristics and mortalities of the patients were determined. Multivariable logistic regression analysis was also performed to determine the factors associated with in-hospital mortality of COPD patients with hip fractures.

Results: Among 5,975 eligible patients, those with hip fractures (n=4,059) were older, had lower body mass index (BMI), and had poorer general condition than those with vertebral (n=1,477), shoulder (n=281), or forearm (n=158) fractures. In-hospital mortality was 7.4%, 5.2%, 3.9%, and 1.3%, respectively. Among the hip fracture group, surgical treatment was significantly associated with lower mortality (adjusted odds ratio, 0.43; 95% confidence interval, 0.32–0.56) after adjustment for patient backgrounds. Higher in-hospital mortality was associated with male sex, lower BMI, lower level of consciousness, and having several comorbidities, including pneumonia, lung cancer, congestive heart failure, chronic liver disease, and chronic renal failure.

Conclusion: COPD patients with hip fractures had higher mortality than COPD patients with other types of fracture. Surgery for hip fracture was associated with lower mortality than conservative treatment.

No MeSH data available.


Flowchart showing the inclusion and exclusion criteria of this study.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC5036626&req=5

f1-copd-11-2335: Flowchart showing the inclusion and exclusion criteria of this study.

Mentions: We retrospectively collected data for patients aged 40 years and older who were admitted to hospital with bone fracture as the main diagnosis on admission, had a diagnosis of COPD, and were discharged between July 1, 2010 and March 31, 2013 (Figure 1). Bone fracture on admission was identified with ICD-10 codes. Hip fracture included fracture of the proximal femur (S720, S721, and S722). Vertebral fracture included fracture of the thoracic and lumbar vertebra (S220, S221, and S320). Shoulder fracture included fracture of the clavicle, scapula, and proximal humerus (S420, S421, and S422). Forearm fracture included fracture of the distal forearm (S525 and S526). The diagnosis of COPD was based on physician-diagnosed COPD, and having COPD on admission was identified with ICD-10 codes (J41, J42, J43, and J44). Patients who were injured in traffic accidents were excluded (V01x–V99x).


Mortality associated with bone fractures in COPD patients
Flowchart showing the inclusion and exclusion criteria of this study.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036626&req=5

f1-copd-11-2335: Flowchart showing the inclusion and exclusion criteria of this study.
Mentions: We retrospectively collected data for patients aged 40 years and older who were admitted to hospital with bone fracture as the main diagnosis on admission, had a diagnosis of COPD, and were discharged between July 1, 2010 and March 31, 2013 (Figure 1). Bone fracture on admission was identified with ICD-10 codes. Hip fracture included fracture of the proximal femur (S720, S721, and S722). Vertebral fracture included fracture of the thoracic and lumbar vertebra (S220, S221, and S320). Shoulder fracture included fracture of the clavicle, scapula, and proximal humerus (S420, S421, and S422). Forearm fracture included fracture of the distal forearm (S525 and S526). The diagnosis of COPD was based on physician-diagnosed COPD, and having COPD on admission was identified with ICD-10 codes (J41, J42, J43, and J44). Patients who were injured in traffic accidents were excluded (V01x–V99x).

View Article: PubMed Central - PubMed

ABSTRACT

Background and objective: COPD is well known to frequently coexist with osteoporosis. Bone fractures often occur and may affect mortality in COPD patients. However, in-hospital mortality related to bone fractures in COPD patients has been poorly studied. This retrospective study investigated in-hospital mortality of COPD patients with bone fractures using a national inpatient database in Japan.

Methods: Data of COPD patients admitted with bone fractures, including hip, vertebra, shoulder, and forearm fractures to 1,165 hospitals in Japan between July 2010 and March 2013, were extracted from the Diagnosis Procedure Combination database. The clinical characteristics and mortalities of the patients were determined. Multivariable logistic regression analysis was also performed to determine the factors associated with in-hospital mortality of COPD patients with hip fractures.

Results: Among 5,975 eligible patients, those with hip fractures (n=4,059) were older, had lower body mass index (BMI), and had poorer general condition than those with vertebral (n=1,477), shoulder (n=281), or forearm (n=158) fractures. In-hospital mortality was 7.4%, 5.2%, 3.9%, and 1.3%, respectively. Among the hip fracture group, surgical treatment was significantly associated with lower mortality (adjusted odds ratio, 0.43; 95% confidence interval, 0.32–0.56) after adjustment for patient backgrounds. Higher in-hospital mortality was associated with male sex, lower BMI, lower level of consciousness, and having several comorbidities, including pneumonia, lung cancer, congestive heart failure, chronic liver disease, and chronic renal failure.

Conclusion: COPD patients with hip fractures had higher mortality than COPD patients with other types of fracture. Surgery for hip fracture was associated with lower mortality than conservative treatment.

No MeSH data available.