Relationship between low basal metabolic rate and mortality in older adults with hip fractures

doi:10.3969/j.issn.2095-4344.0218

Abstract

Abstract:

BACKGROUND: Basal metabolic rate (BMR) is an important indicator of human energy metabolism, and low BMR leads to the dysfunction of liver and kidney. Low BMR is usually found in patients with hip fractures, but there is a lack of study on the relationship between mortality of hip fracture and low BMR.
OBJECTIVE: To investigate the effect of low BMR on the 1-year mortality in older adults with hip fractures.
METHODS: Totally 507 patients with hip fractures aged more than 60 years from January 2014 to March 2016 were included in this retrospective study. Age, sex, surgery or not, surgical pathway, duration from injury to surgery, hospitalized pulmonary infection, number and kind of comorbidities, and 1-year mortality were recorded. BMR on admission was recorded, and multiple Logistic regression analysis was applied.
RESULTS AND CONCLUSION: All patients were followed up for 13-15 months, and the 1-year mortality was 13.41% (68/507). The mortality in the low BMR group was significantly higher than that in the non-low BMR group (P < 0.05). Logistic regression analysis showed that older age, conventional treatment, number of combined medical diseases, hospitalized pulmonary infection, and low BMR are risk factors for 1-year mortality in older adults with hip fracture. These results imply that low BMR is strongly associated with 1-year mortality in older adults with hip fracture. BMR can reflect the nutritional status, neuroendocrine, cellular and energy metabolism. Thereafter, for older adults with hip fractures and low BMI, nutrition therapy, re-warming, and endocrine therapy may help reduce the trauma-induced mortality.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Tissue Engineering, Fractures, Bone, Mortality, Basal Metabolism

CLC Number:

R318

Sun Chun-sheng, Zheng Xin, Guo Kai-jin, Li Dong-ya, Li Cheng-yu, Wang Yi, Chang Bu-qing, Feng Shuo, . Relationship between low basal metabolic rate and mortality in older adults with hip fractures[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(16): 2467-2471.

Figures/Tables 3

References

[1] Cooper C, Cole ZA, Holroyd CR, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011;22(5):1277.

[2] Xia WB, He SL, Xu L, et al. Rapidly increasing rates of hip fracture in Beijing, China. J Bone Miner Res. 2012;27(1):125-129.

[3] Torpilliesi T, Bellelli G, Morghen S, et al. Outcomes of nonagenarian patients after rehabilitation following hip fracture surgery. J Am Med Dir Assoc. 2012;13(1):1-5.

[4] Kayatas K, Sahin G, Tepe M, et al. Acute kidney injury in the elderly hospitalized patients. Ren Fail. 2014;36(8):1273-1277.

[5] Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study. Arch Osteoporos. 2017;12(1):67.

[6] 王培文,李毅中,林金矿,等.脆性髋部骨折的近期死亡率及相关危险因素研究[J].中华骨科杂志,2014,34(7):730-735.

[7] 石忠琪.老年髋部骨折的诊断与治疗[J].医学综述, 2008,14(10): 1520-1522.

[8] Kannegaard PN, Van dMS, Eiken P, et al. Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing. 2010; 39(2):203.

[9] Carretta E, Bochicchio V, Rucci P, et al. Hip fracture: effectiveness of early surgery to prevent 30-day mortality. Int Orthop.2011;35(3): 419-24.

[10] Chatterton BD, Moores TS, Ahmad S, et al. Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Joint J. 2015;97-B(2):246.

[11] Cha YH, Ha YC, Yoo JI, et al. Effect of causes of surgical delay on early and late mortality in patients with proximal hip fracture. Arch Orthop Trauma Surg. 2017;137(5):625-630.

[12] Wu LC, Chou MY, Liang CK, et al. Factors affecting one-year mortality of elderly patients after surgery for hip fracture. Int J Gerontol. 2016;10(4):207-211.

[13] Karademir G, Bilgin Y, Er?en A, et al. Hip fractures in patients older than 75 years old: Retrospective analysis for prognostic factors. Int J Surg. 2015;24(Pt A):101-104.

[14] Ercin E, Bilgili MG, Sari C, et al. Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients. Eur J Orthop Surg Traumatol. 2016:1-6.

[15] Vidal E, Moreira-Filho D, Pinheiro R, et al. Delay from fracture to hospital admission: a new risk factor for hip fracture mortality? Osteoporos Int. 2012;23(12):2847-2853.

[16] Roche JJW. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331(7529): 1374-1370.

[17] Hong SE, Kim TY, Yoo JH, et al. Acute kidney injury can predict in-hospital and long-term mortality in elderly patients undergoing hip fracture surgery. PLoS One. 2017;12(4):e0176259.

[18] Jürisson M, Raag M, Kallikorm R, et al. The impact of comorbidities on hip fracture mortality: a retrospective population-based cohort study. Arch Osteoporos. 2017;12(1):76.

[19] Tsuei BJ, Kearney PA. Hypothermia in the trauma patient. Injury. 2004;35(1):7-15.

[20] Moffatt SE. Hypothermia in trauma. Emerg Med J. 2013;30(12): 989-996.

[21] Faizi M, Farrier AJ, Venkatesan M, et al. Is body temperature an independent predictor of mortality in hip fracture patients? Injury. 2014;45(12):1942-1945.

[22] Murphy MC, Brooks CN, New SA, et al. The use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopaedic patients. Eur J Clin Nutr. 2000;54(7):555.

[23] Li HJ, Cheng HS, Liang J, et al. Functional recovery of older people with hip fracture: does malnutrition make a difference? J Adv Nurs. 2013;69(8):1691-1703.

[24] Korenhakim T, Weiss A, Hershkovitz A, et al. The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome. Clin Nutr. 2012; 31(6):917-921.

[25] Carlsson P, Tidermark J, Ponzer S, et al. Food habits and appetite of elderly women at the time of a femoral neck fracture and after nutritional and anabolic support. J Hum Nutr Diet. 2005;18(2): 117.

[26] Inzitari M, Doets E, Bartali B, et al. Nutrition in the age-related disablement process. J Nutr Health Aging. 2011;15(8):599-604.

[27] Engelking LR. Chapter 75-Starvation (The Intermediate Phase). Textbook of Veterinary Physiological Chemistry. 2015:476-481.

[28] Larsen PR, Davies TF, Schlumberger MJ, et al. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. 2011.

[29] Docter R, Krenning EP, Jong MD, et al. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf). 2010;39(5):499-518.

[30] Galusova A, Pauliny M, Majek M, et al. Dynamic neuroendocrine changes in critically ill patients with polytrauma. Neuro Endocrinol Lett. 2015;36(5):498-503.

[31] Greenspan L, Mclellan BA, Greig H. Abbreviated Injury Scale and Injury Severity Score: a scoring chart. J Trauma. 1985;25(1): 60-64.