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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Immediate Risk for Cardiovascular Events in Hip Fracture Patients: A Population-Based Cohort Study

Warrington W Q Hsu1, Chor-Wing Sing1, Gloria H Y Li2

  • 1Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|November 8, 2021
PubMed

Insights

Hip fracture increases the immediate risk of major adverse cardiovascular events (MACEs). Prompt MACE evaluation in older adults with hip fracture is crucial for early management and reducing subsequent cardiovascular risk.

Area of Science:

  • Gerontology
  • Cardiology
  • Orthopedics

Background:

  • Bone metabolism and cardiovascular disease (CVD) share a close relationship.
  • Previous research indicated a potential immediate risk of cardiovascular mortality post-hip fracture.
  • The immediate risk of cardiovascular events following hip fracture remains unclear.

Purpose of the Study:

  • To evaluate the risk of major adverse cardiovascular events (MACEs) in patients experiencing falls with and without hip fracture.
  • To investigate the association between hip fracture and the subsequent risk of MACEs.

Main Methods:

  • Retrospective, population-based cohort study utilizing Hong Kong Hospital Authority electronic health records.
  • Propensity score matching (1:1 ratio) for patients with and without hip fracture after falls.
  • Competing risk regression analysis to assess adjusted associations between hip fracture and MACEs, accounting for mortality.

Main Results:

  • Hip fracture was significantly associated with an increased 1-year risk of MACEs (HR: 1.27, 95% CI: 1.21-1.33).
  • The cumulative incidence difference for MACEs at 1 year was 2.40%.
  • The highest hazard ratio for MACEs occurred within the first 90 days post-hip fracture, gradually decreasing over 1 year.

Conclusions:

  • Hip fracture is linked to an elevated immediate risk of major adverse cardiovascular events.
  • Prompt MACE evaluation in older adults (≥65 years) diagnosed with hip fracture is recommended, regardless of pre-existing cardiovascular risk factors.
  • Early management following hip fracture may mitigate the subsequent risk of MACEs.
Abstract

Keywords:
Major adverse cardiovascular eventsOsteoporosisPropensity score matchingUnintentional falls

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