Risk of all-cause mortality in elderly patients with hip fractures treated with denosumab
Abstract
Abstract Background Hip fractures markedly increase the risk of all-cause mortality and subsequent fractures. Although prior meta-analyses and clinical trials such as Health Outcomes and Reduced Incidence with zoledronic acid Once Yearly (HORIZON ) Recurrent Fracture Trial have suggested that zoledronic acid may reduce mortality, large-scale database studies are often limited by residual confounding. AIM Using detailed clinical data from a geriatric fracture center, this study evaluated whether denosumab treatment reduces mortality in real-world elderly hip fracture patients. Methods This cohort study included 738 patients aged ≥ 65 years with fragility hip fracture. The treatment group (n = 368) received at least one dose of denosumab postoperatively plus calcium/vitamin D, while the control group (n = 370) received calcium/vitamin D only. Primary outcomes were all-cause mortality. Multivariate Cox models were used to adjust for age, sex, Charlson Comorbidity Index (CCI), and other potential confounders. Results During follow-up, 62 deaths (8.4%) occurred. Male (HR = 2.61, 95% CI: 1.38–4.92, p = 0.003), age ≥ 85 years (HR = 10.40, 95% CI: 3.82–28.33, p 3 (HR = 7.40, 95% CI: 2.91–18.82, p
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 738 participants or records.
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