Mortality after inpatient stay for proximal humeral fractures

J Shoulder Elbow Surg. 2020 Jan;29(1):e22-e28. doi: 10.1016/j.jse.2019.05.030. Epub 2019 Aug 26.

Abstract

Background: A proximal humeral fracture is well established as a fracture of fragility in elderly patients. However, this injury does not receive the same emphasis on post-injury management as a femoral neck fracture. The objectives of this study were to establish the influence of sustaining a proximal humeral fracture on mortality and to identify the variables predictive of 5-year mortality.

Methods: Between January 2007 and January 2011, 288 consecutive patients who were admitted after sustaining a proximal humeral fracture were identified from the clinical coding department. Data were retrospectively collected and included patient demographic characteristics, comorbidities, anemia, physical and social independence, length of inpatient stay, management, and mortality.

Results: Of the patients, 13 (4.5%) had died at 1 month; 28 (9.7%), at 3 months; 46 (16.0%), at 1 year; and 117 (40.6%), at 5 years. A Cox proportional hazards regression identified male sex, comorbidities, unemployment or retirement, and nonoperative management as independent predictors of 5-year mortality.

Conclusions: Elderly patients who require admission after sustaining a proximal humeral fracture are frail and subject to a greater-than-average risk of mortality for their age. The risk of mortality is greater for those of male sex who have comorbidities and a loss of physical and social independence.

Keywords: Upper-extremity fracture; admission; elderly; fragility fracture; inpatient; mortality; osteoporosis; proximal humeral fracture.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Conservative Treatment / statistics & numerical data
  • Female
  • Frailty / complications
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retirement / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Shoulder Fractures / complications
  • Shoulder Fractures / mortality*
  • Shoulder Fractures / therapy*
  • Unemployment / statistics & numerical data