Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

<p>Abstract</p> <p>Background</p> <p>The high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population.</p> <p>Methods</p> <p>Records of 428 consecutive hip fracture patients were collected on a population-basis and data on the general population comprising all Finns 65 years of age or older were collected on a cohort-basis. Cause of death was classified as follows: malignant neoplasms, dementia, circulatory disease, respiratory disease, digestive system disease, and other.</p> <p>Results</p> <p>Mean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the follow-up, age-adjusted mortality after hip fracture surgery was higher in men than in women with hazard ratio (HR) 1.55 and 95% confidence interval (95% CI) 1.21-2.00. Among hip surgery patients, the most common causes of death were circulatory diseases, followed by dementia and Alzheimer's disease. After hip fracture, men were more likely than women to die from respiratory disease, malignant neoplasm, and circulatory disease. During the follow-up, all-cause age- and sex-standardized mortality after hip fracture was 3-fold higher than that of the general population and included every cause-of-death category.</p> <p>Conclusion</p> <p>During the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.</p

Effects of risk-based multifactorial fall prevention on health-related quality of life among the community-dwelling aged: a randomized controlled trial

BACKGROUND: This study aimed to assess the effects of a risk-based, multifactorial fall prevention programme on health-related quality of life among the community-dwelling aged who had fallen at least once during the previous 12 months. METHODS: The study is a part of a single-centre, risk-based, multifactorial randomised controlled trial. The intervention lasted for 12 months and consisted of a geriatric assessment, guidance and treatment, individual instruction in fall prevention, group exercise, lectures on themes related to falling, psychosocial group activities and home exercise. Of the total study population (n = 591, 97% of eligible subjects), 513(251 in the intervention group and 262 in the control group) participated in this study. The effect of the intervention on quality of life was measured using the 15D health-related quality of life instrument consisting of 15 dimensions. The data were analysed using the chi-square test or Fisher's exact test, the Mann-Whitney U-test and logistic regression. RESULTS: In men, the results showed significant differences in the changes between the intervention and control groups in depression (p = 0.017) and distress (p = 0.029) and marginally significant differences in usual activities (p = 0.058) and sexual activity (p = 0.051). In women, significant differences in the changes between the groups were found in usual activities (p = 0.005) and discomfort/symptoms (p = 0.047). For the subjects aged 65 to 74 years, significant differences in the changes between the groups were seen in distress (p = 0.037) among men and in usual activities (p = 0.011) among women. All improvements were in favour of the intervention group. CONCLUSION: Fall prevention produced positive effects on some dimensions of health-related quality of life in the community-dwelling aged. Men benefited more than women

Decay and Transmutation of Nuclides

We present a computer code DeTra which solves analytically the Bateman equations governing the decay, build-up and transmutation of radionuclides. The complexity of the chains and the number of nuclides are not limited. The nuclide production terms considered include transmutation of the nuclides inside the chain, external production, and fission. Time dependent calculations are possible since all the production terms can be re-defined for each irradiation step. The number of irradiation steps and output times is unlimited. DeTra is thus able to solve any decay and transmutation problem as long as the nuclear data i.e. decay data and production rates, or cross sections, are known

Production of Long-Lived Radionuclides in CMS

We discuss the production of radionuclides which are of significance when assessing the amount of radioactive material to be deposited or recycled after decommissioning of CMS. Our estimate is based on a detailed accounting for each individual radionuclide and accurate follow-up of the time dependence of the activity. Compared to a previous study using crude parametrizations the new results indicate significantly lower amounts of radioactive material. According to the new estimate the amount of active ( &gt; 1 Bq/g) material from CMS, 30 years after LHC shutdown, will be 150 tons. Only the collimators, none of the CMS proper, will fall into the &gt;100 Bq/g category after 30 years of cooling