The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China

Objectives To evaluate the association between heart rate on admission and mortality in elderly patients with hip fractures.Design A retrospective cohort study.Setting At a trauma centre in northwestern China.Participants Elderly patients with hip fractures.Results This cohort study included 2006 pa...

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Main Authors: Zhi Yang, Wei-Song Zhang, Shao-Hua Chen, Bin-Fei Zhang
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e093662.full
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author Zhi Yang
Wei-Song Zhang
Shao-Hua Chen
Bin-Fei Zhang
author_facet Zhi Yang
Wei-Song Zhang
Shao-Hua Chen
Bin-Fei Zhang
author_sort Zhi Yang
collection DOAJ
description Objectives To evaluate the association between heart rate on admission and mortality in elderly patients with hip fractures.Design A retrospective cohort study.Setting At a trauma centre in northwestern China.Participants Elderly patients with hip fractures.Results This cohort study included 2006 patients who met the study criteria. The mean heart rate at admission was 81.77±15.63 beats per minute. During follow-up, 189 patients died for all-cause reasons in 1 year. Age, coronary heart disease, cancer, dementia and time to operation were introduced in multivariate regression analysis. Multivariate logistic regression showed that heart rate was associated with mortality in geriatric patients with hip fracture (OR=1.01, 95% CI 1.00 to 1.02, p=0.0242). However, the linear association was unstable, and we found a nonlinear one. In the nonlinear association, the inflection point was 84 beats per minute. If below this threshold, each 1 beat per minute increase in heart rate was associated with a 4% increase in the risk of death (OR=1.04, 95% CI 1.01 to 1.06, p=0.0017). If greater than this threshold, the risk of death peaked and was not associated with the heart rate (OR=1.00, 95% CI 0.98 to 1.01, p=0.6691).Conclusion In conclusion, the heart rate was nonlinearly associated with 1-year mortality in geriatric patients with hip fractures. The low heart rate on admission was associated with low 1-year mortality. When the heart rate was over 84 beats per minute, the risk of death peaked, and there was no association with heart rate anymore.Trial registration number This study was registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).
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spelling doaj-art-d2599b1a0fe948bfbcd186647c43e5b92025-01-09T11:55:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-093662The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern ChinaZhi Yang0Wei-Song Zhang1Shao-Hua Chen2Bin-Fei Zhang3Department of Joint Surgery, Honghui Hospital, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaDepartment of Joint Surgery, Honghui Hospital, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaDepartment of Joint Surgery, Honghui Hospital, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaDepartment of Joint Surgery, Honghui Hospital, Xi`an Jiaotong University, Xi`an, Shaanxi, ChinaObjectives To evaluate the association between heart rate on admission and mortality in elderly patients with hip fractures.Design A retrospective cohort study.Setting At a trauma centre in northwestern China.Participants Elderly patients with hip fractures.Results This cohort study included 2006 patients who met the study criteria. The mean heart rate at admission was 81.77±15.63 beats per minute. During follow-up, 189 patients died for all-cause reasons in 1 year. Age, coronary heart disease, cancer, dementia and time to operation were introduced in multivariate regression analysis. Multivariate logistic regression showed that heart rate was associated with mortality in geriatric patients with hip fracture (OR=1.01, 95% CI 1.00 to 1.02, p=0.0242). However, the linear association was unstable, and we found a nonlinear one. In the nonlinear association, the inflection point was 84 beats per minute. If below this threshold, each 1 beat per minute increase in heart rate was associated with a 4% increase in the risk of death (OR=1.04, 95% CI 1.01 to 1.06, p=0.0017). If greater than this threshold, the risk of death peaked and was not associated with the heart rate (OR=1.00, 95% CI 0.98 to 1.01, p=0.6691).Conclusion In conclusion, the heart rate was nonlinearly associated with 1-year mortality in geriatric patients with hip fractures. The low heart rate on admission was associated with low 1-year mortality. When the heart rate was over 84 beats per minute, the risk of death peaked, and there was no association with heart rate anymore.Trial registration number This study was registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).https://bmjopen.bmj.com/content/15/1/e093662.full
spellingShingle Zhi Yang
Wei-Song Zhang
Shao-Hua Chen
Bin-Fei Zhang
The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
BMJ Open
title The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
title_full The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
title_fullStr The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
title_full_unstemmed The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
title_short The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China
title_sort heart rate on admission was associated with the mortality in elderly patients with hip fractures a retrospective cohort study from a trauma centre in northwestern china
url https://bmjopen.bmj.com/content/15/1/e093662.full
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