Hip Fracture Treatment and Outcomes Among Community-Dwelling People Living With Dementia
Authors' conclusion
In this cohort study of community-dwelling patients with dementia and fracture of the femoral head and neck, patients with MSD and mild dementia treated surgically experienced lower odds of death compared with patients treated nonsurgically.
Study context
- Population
- Community-dwelling Medicare beneficiaries with dementia and an inpatient claim for hip fracture, January 1, 2017, to June 30, 201873.0% women
- Participants
- 56,209 beneficiaries
- Exposure
- Surgical vs nonsurgical treatment for hip fracture
- Surgicaln = 33,142
- Nonsurgicaln = 23,067reference
- Outcome
- Mortality within 30, 90, and 180 days
- Follow-up
- 30, 90, and 180 days
Methodological detailspopulation-based, national Medicare fee-for-service data
- Population-based
- National Medicare fee-for-service data
Main finding
As reported in the abstract
180-day mortality, moderate to severe dementia (MSD) with femoral head and neck fracture · 180 days
Each group vs nonsurgicalEstimate (95% CI)P value
Surgical
OR (unadjusted), MSD 0.56(0.49–0.62)
P < 0.001Surgical
aOR, MSD 0.59(0.53–0.66)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | Surgical | Nonsurgical | Estimate | P value | |
|---|---|---|---|---|---|
| 180-day mortality, mild dementia with femoral head and neck fracture | 26.5% | 34.9% | OR (unadjusted) 0.67 (95% CI 0.60–0.76) | P < 0.001 | |
| 180-day mortality, mild dementia with femoral head and neck fracture | aOR 0.71 (95% CI 0.63–0.79) | P < 0.001 | |||
| 0.512Ratio (log scale) |
Nursing home admission within 180 days, femoral head and neck fracture
- No difference when treated surgically vs nonsurgically
Original publication
Hip Fracture Treatment and Outcomes Among Community-Dwelling People Living With Dementia. JAMA Netw Open. Published 1 May 2024. doi:10.
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