BACKGROUND The aim of this study was to describe long-term (10-year) patient survival after arthroplasty for hip fracture and to determine what patient factors are associated with that outcome. METHODS We performed a retrospective cohort analysis of patients ≥60 years old who underwent either hemiarthroplasty or total hip arthroplasty for femoral neck fracture between 2002 and 2009. We used routinely collected, validated health-care databases linked through ICES (formerly known as the Institute for Clinical Evaluative Sciences). We estimated the association between baseline variables and survival 10 years post-fracture using Poisson regression. Restricted cubic spline functions modeled the probability of 10-year survival by age and tested whether there was an inflection point after which the probability of 10-year survival decreased more rapidly. We estimated 10-year survival probabilities for different patient groups. RESULTS There were 19,659 patients in the final cohort. Eighteen percent (3,564) of the patients were alive at 10 years postoperatively. Factors associated with a higher likelihood of 10-year survival included younger age, female sex (risk ratio [RR] = 1.56, 95% confidence interval [CI] = 1.46 to 1.68), lower American Society of Anesthesiologists (ASA) class (ASA I or II versus IV or V: RR = 1.96, 95% CI = 1.76 to 2.19), independent living status (RR = 2.68, 95% CI = 2.23 to 3.22), and fewer specific comorbidities. A threshold age of 73 years was the inflection point after which the probability of 10-year survival decreased more rapidly in females. Estimated 10-year survival probabilities ranged from 79.0% (95% CI = 75.5% to 82.5%) to 0.8% (95% CI = 0.6% to 1.0%). CONCLUSIONS Approximately 1 in 6 patients live at least 10 years following a hip fracture. This study identifies baseline characteristics that predict survival greater than 10 years, including an age of <75 years, an ASA class of I or II, and independent living status prior to the hip fracture. Results can inform discussions around treatment choices, anticipated outcomes, and the natural history of hip fractures. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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与髋部骨折关节置换术后 10 年生存相关的患者因素：加拿大安大略省的一项基于人群的研究。


背景 本研究的目的是描述髋部骨折关节置换术后患者的长期（10 年）生存率，并确定哪些患者因素与该结果相关。方法 我们对 2002 年至 2009 年间因股骨颈骨折接受半髋关节置换术或全髋关节置换术的 60 岁以上患者进行了回顾性队列分析。我们使用通过 ICES（以前称为研究所）链接的常规收集、经过验证的医疗保健数据库。临床评价科学）。我们使用泊松回归估计了基线变量与骨折后 10 年生存率之间的关联。受限三次样条函数对按年龄划分的 10 年生存概率进行了建模，并测试是否存在拐点，在此之后 10 年生存概率下降得更快。我们估计了不同患者群体的 10 年生存概率。结果 最终队列中有 19,659 名患者。术后 10 年，百分之十八 (3,564) 的患者仍存活。与 10 年生存率较高可能性相关的因素包括年龄较小、女性（风险比 [RR] = 1.56，95% 置信区间 [CI] = 1.46 至 1.68）、较低的美国麻醉医师协会 (ASA) 等级 (ASA) I 或 II 与 IV 或 V 相比​​：RR = 1.96，95% CI = 1.76 至 2.19），独立生活状态（RR = 2.68，95% CI = 2.23 至 3.22），以及较少的特定合并症。 73 岁是一个临界年龄，此后女性 10 年生存概率下降得更快。估计 10 年生存概率范围为 79.0%（95% CI = 75.5% 至 82.5%）至 0.8%（95% CI = 0.6% 至 1.0%）。结论 大约六分之一的髋部骨折患者至少还能存活 10 年。 本研究确定了预测生存期超过 10 年的基线特征，包括 <75 岁的年龄、ASA I 级或 II 级以及髋部骨折前的独立生活状态。结果可以为有关治疗选择、预期结果和髋部骨折自然史的讨论提供信息。证据级别 预后 III 级。有关证据级别的完整描述，请参阅作者须知。