Mortality associated with bone fractures in COPD patients

Figures & data

Figure 1 Flowchart showing the inclusion and exclusion criteria of this study.

Table 1 Clinical characteristics of COPD patients on admission

	Total		Hip		Vertebra		Shoulder		Forearm		P-value
	n=5,975	(%)	n=4,059	(%)	n=1,477	(%)	n=281	(%)	n=158	(%)
Age (years)a	82.1 (8.2)		83.2 (7.9)		80.7 (7.5)		77.4 (10.2)		75.3 (9.0)		<0.001
40–79	1,874	(31.4)	1,069	(26.3)	567	(38.4)	136	(48.4)	102	(64.6)
≥80	4,101	(68.6)	2,990	(73.7)	910	(61.6)	145	(51.6)	56	(35.4)
Sex											<0.001
Male	3,122	(52.3)	2,087	(51.4)	845	(57.2)	150	(53.4)	40	(25.3)
Female	2,853	(47.7)	1,972	(48.6)	632	(42.8)	131	(46.6)	118	(74.7)
BMI (kg/m^2)a	19.7 (3.7)		19.3 (3.6)		20.2 (3.9)		20.7 (3.9)		22.0 (4.3)		<0.001
<18.5	2,198	(36.8)	1,609	(39.6)	478	(32.4)	82	(29.2)	29	(18.4)
18.5–24.9	2,753	(46.1)	1,814	(44.7)	701	(47.5)	145	(51.6)	93	(58.9)
≥25.0	440	(7.4)	227	(5.6)	152	(10.3)	31	(11.0)	30	(19.0)
Missing	584	(9.8)	409	(10.1)	146	(9.9)	23	(8.2)	6	(3.8)
Level of consciousness											<0.001
Clear	5,410	(90.6)	3,601	(88.7)	1,392	(94.2)	263	(93.6)	154	(97.5)
Drowsy	533	(8.9)	431	(10.6)	81	(5.5)	17	(6.0)	4	(2.5)
Coma	31	(0.5)	26	(0.6)	4	(0.3)	1	(0.4)	0	(0.0)
Activities of daily living											<0.001
Independent	1,067	(17.9)	406	(10.0)	383	(25.9)	162	(57.7)	116	(73.4)
Dependent	3,654	(61.2)	2,762	(68.0)	796	(53.9)	73	(26.0)	23	(14.6)
Missing	1,254	(21.0)	891	(22.0)	298	(20.2)	46	(16.4)	19	(12.0)

Notes:

a Data expressed as mean (standard deviation). Missing refers to lack of data.

Abbreviation: BMI, body mass index.

Table 2 Patient comorbidities on admission

	Total		Hip		Vertebra		Shoulder		Forearm		P-value
	n=5,975	(%)	n=4,059	(%)	n=1,477	(%)	n=281	(%)	n=158	(%)
Pneumonia	500	(8.4)	389	(9.6)	94	(6.4)	14	(5.0)	3	(1.9)	<0.001
Asthma	692	(11.6)	437	(10.8)	196	(13.3)	31	(11.0)	28	(17.7)	0.005
Interstitial pneumonia	97	(1.6)	56	(1.4)	38	(2.6)	3	(1.1)	0	(0.0)	0.005
Lung cancer	184	(3.1)	108	(2.7)	65	(4.4)	9	(3.2)	2	(1.3)	0.005
Congestive heart failure	674	(11.3)	496	(12.2)	151	(10.2)	19	(6.8)	8	(5.1)	0.001
Ischemic heart disease	605	(10.1)	411	(10.1)	143	(9.7)	27	(9.6)	24	(15.2)	0.183
Arrhythmia	302	(5.1)	223	(5.5)	62	(4.2)	10	(3.6)	7	(4.4)	0.149
Cerebrovascular disease	569	(9.5)	419	(10.3)	120	(8.1)	20	(7.1)	10	(6.3)	0.018
Chronic liver disease	88	(1.5)	61	(1.5)	24	(1.6)	0	(0.0)	3	(1.9)	0.199
Chronic renal failure	149	(2.5)	115	(2.8)	28	(1.9)	5	(1.8)	1	(0.6)	0.074

Table 3 Clinical course and outcomes

	Total		Hip		Vertebra		Shoulder		Forearm		P-value
	n=5,975	(%)	n=4,059	(%)	n=1,477	(%)	n=281	(%)	n=158	(%)
Death	389	(6.5)	299	(7.4)	77	(5.2)	11	(3.9)	2	(1.3)	<0.001
Length of stay, daysa	31 (20–50)		34 (22–53)		29 (19–47)		23 (12–36)		12 (5–12)		<0.001
With surgery	3,476	(58.2)	3,220	(79.3)	63	(4.3)	165	(58.7)	88	(55.7)	<0.001
Deathb	177	(5.1)	170	(5.3)	3	(4.8)	4	(2.4)	0	(0.0)	0.055
Without surgery	2,499	(41.8)	839	(20.7)	1,474	(95.7)	116	(41.3)	70	(44.3)
Deathc	212	(8.6)	129	(15.4)	74	(5.2)	7	(6.1)	2	(2.9)	<0.001

Notes:

a Median (interquartile range);

b percentage among patients with surgery;

c percentage among patients without surgery.

Table 4 Multivariable logistic regression analysis of COPD patients with hip fractures (n=4,059)

	aOR	95% CI	P-value
Age (years)
40–79	Ref
≥80	1.21	0.89–1.66	0.229
Sex
Male	Ref
Female	0.42	0.32–0.56	<0.001
BMI (kg/m^2)
<18.5	2.10	1.58–2.79	<0.001
18.5–24.9	Ref
≥25.0	0.63	0.27–1.45	0.276
Missing	2.47	1.64–3.70	<0.001
Level of consciousness
Clear	Ref
Drowsy	1.36	0.91–2.03	0.137
Coma	3.70	1.36–10.07	0.010
Activity of daily living
Independent	Ref
Dependent	1.12	0.71–1.78	0.954
Missing	0.94	0.55–1.58	0.805
Surgery with anesthesia
Yes	0.43	0.32–0.56	<0.001
Comorbidities
Pneumonia	4.65	3.47–6.23	<0.001
Asthma	1.04	0.64–1.68	0.713
Interstitial pneumonia	4.47	2.12–9.41	<0.001
Lung cancer	2.47	1.33–4.59	0.004
Congestive heart failure	1.95	1.40–2.72	<0.001
Ischemic heart disease	1.41	0.95–2.09	0.090
Arrhythmia	1.45	0.89–2.38	0.140
Cerebrovascular disease	0.84	0.52–1.36	0.480
Chronic liver disease	2.60	1.17–5.77	0.019
Chronic renal failure	1.88	1.00–3.53	0.050

Note: Missing refers to lack of data.

Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; Ref, reference; BMI, body mass index.