Evidence mapPaperPMID 40202613Full record

Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Pre-fracture functional status and 30-day recovery predict 5-year survival in patients with hip fracture: findings from a prospective real-world study.

Carmelinda Ruggiero, Marta Baroni, Monica Pizzonia, Andrea Giusti, Giuseppe Rinonapoli, Vittorio Bini, Emilio Martini, Ilaria Giovanna Macchione, Clemens Becker, Opinder Sahota and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. From bench to bedside: a novel suture-augmented prosthesis for greater trochanteric fixation in osteoporotic hip arthroplasty.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Carmelinda RuggieroOrthogeriatric and Geriatric Units, Gerontology and Geriatrics Section, Department of Medicine and Surgery, University of Perugia, S. Maria Misericordia Hospital, C Building, 4° Floor, Room 20, S. Andrea delleFratte, 06156, Perugia, Italy. carmelinda.ruggiero@unipg.it.ORCID http://orcid.org/0000-0002-1245-1963
Marta BaroniOrthogeriatric and Geriatric Units, Gerontology and Geriatrics Section, Department of Medicine and Surgery, University of Perugia, S. Maria Misericordia Hospital, C Building, 4° Floor, Room 20, S. Andrea delleFratte, 06156, Perugia, Italy.
Monica PizzoniaIRCCS Policlinico San Martino Hospital, Genoa, Italy.
Andrea GiustiUnit of Internal Medicine and Metabolic Bone Diseases, Villa Scassi, 16149, Genoa, Italy.
Giuseppe RinonapoliOrthopedics and Traumatology Department, University of Perugia, Perugia, Italy.
Vittorio BiniOrthogeriatric and Geriatric Units, Gerontology and Geriatrics Section, Department of Medicine and Surgery, University of Perugia, S. Maria Misericordia Hospital, C Building, 4° Floor, Room 20, S. Andrea delleFratte, 06156, Perugia, Italy.
Emilio MartiniGeriatric and Orthogeriatric Unit, Baggiovara Hospital, Modena, Italy.
Ilaria Giovanna MacchioneOrthogeriatric and Geriatric Units, Gerontology and Geriatrics Section, Department of Medicine and Surgery, University of Perugia, S. Maria Misericordia Hospital, C Building, 4° Floor, Room 20, S. Andrea delleFratte, 06156, Perugia, Italy.
Clemens BeckerDepartment Clinical Gerontology and Geriatric Rehabilitation, Bosch Hospital, Stuttgart, Germany.
Opinder SahotaDepartment of Healthcare of Older People and Department of Trauma and Orthopaedics, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Antony JohansenUniversity Hospital of Wales and School of Medicine, Cardiff University, Cardiff, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Disability overcomes mortality burden in older adults with hip fracture, expanding unhealthy lifespan. Building comprehensive assessment, pre-fracture functional status and 30-day post-surgical recovery are the most powerful predictors of 5-years survival. A tool supporting estimation of long-term survival may optimize the appropriate delivery of targeted interventions.

backgroundOlder people with hip fractures are highly heterogeneous patients, impacting health and economic systems. The availability of tools to estimate survival may help optimize patients' outcomes and treatment management decisions.

methodsA prospective observational study was conducted on older patients with hip fractures who received baseline and 30-day comprehensive assessment from discharge, focusing on functional status based on Basic Activity of Daily Living (BADL). The primary outcome was to identify predictors of 5-year survival and develop nomograms to be adopted at admission or 30 days after discharge.

resultAmong 231 hip fracture patients, 5-year survival was 38.3% in men and 61.9% in women; women experienced a 1.8 higher likelihood of survival than men. Pre-fracture functional status predicted mortality as a function of age. At hospital admission, pre-fracture BADL level was a protective factor (HR 0.742; 95% CI 0.668-0.825), while male gender (HR 1.840; 95% CI 1.192-2.841), age (HR 1.070; 95% CI 1.037-1.105), and multimorbidity (HR 1.096; 95% CI 1.007-1.193) were independent mortality risk factors. At the 30-day follow-up visit, the BADL recovery gap was an independent predictor of 5-year survival (HR 1.439; 95% CI 1.158-1.789), in addition to male gender (HR 1.773; 95% CI 1.146-2.744), age (HR 1.046; 95% CI 1.010-1.083), and pre-fracture BADL (HR 0.621; 95% CI 0.528-0.730), while comorbidity disappeared (HR 1.083; 95% CI 0.994-1.179).

conclusionMore than half of hip fracture patients are still alive 5 years after surgical repair. Pre-fracture functional status and a 30-day functional recovery gap are the main predictors of survival. Nomograms may help to define prognosis and suitable interventions.

Indexed as

Functional StatusHip FracturesOsteoporotic FracturesActivities of Daily LivingAgedAged, 80 and overAge FactorsFemaleGeriatric AssessmentHumansMaleNomogramsPrognosisProspective StudiesRecovery of FunctionSex FactorsFragility fracturesFunctional autonomyHip fractureNomogramSurvival

Identifiers

PMID40202613
PMCPMC12122634

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.