ECTS Abstracts (2015) 1 P257

Pre-Fracture Medication use as Predictor of 30- And 365 Day Mortality in Hip Fracture Patients

Christopher Jantzen1, Christian M. Madsen1, Troels Riis1, Susanne Van Der Mark1, Benn R. Duus1, Henrik L. Jørgensen2 & Jes B. Lauritzen1

1Department of Orthopaedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; 2Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.

Background: Hip fractures are associated with increased mortality, which is influenced by several previously described factors, but information on the effect of pre-fracture medication usage is sparse. The purpose of this study was to examine the association between pre-fracture medication and 30- and 365 day mortality following a hip fracture.

Methods: All patients sustaining a hip fracture and admitted to our hospital have since August 2008 been registered in the local hip fracture database. All patients >60 years admitted in the period September 2008 to January 2012 were identified for this study. The following variables were obtained from the database: habitual medication use, American Society of Anaesthesiologist grading score (ASA-score), body mass index (BMI), age, sex and date of death. Univariate- and multivariate Cox regression analyses were conducted in order to examine the correlation between pre-fracture medication usage and hazard ratio (HR) for death. Adjustments were made for age, sex, ASA-score, BMI, fracture type, operation type and dwelling before admission. A P-value <0.05 was considered statistical significant.

Results: 1404 consecutive patients were included. In the multivariate analyses, a significant increase in 365 day mortality was associated with the use of acetaminophen (HR 1.24) and digoxin (HR 1.38) while 30 day mortality was increased in patients using benzodiazepines (HR 1.60), beta-blockers (1.70) and propulsives (HR 2.19). A significant decrease in 365 days mortality was associated with the use of bisphosphonates (HR 0.56). For statins, a borderline significant (P=0.05) reduction in 365 mortality was found (HR 0.76).

Conclusion: This study shows the correlation between pre-fracture usage of certain medications and mortality following a hip fracture. The information might be used to identify patients with a higher risk of death and thus result in intensified care in order to reduce excess mortality.

Disclosure: The authors declared no competing interests.

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