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Zhonglun Zhu,1,* Zhicong Wang,1,2,* Yuxuan Wu,1,* Xi Chen,1 Hailong Liu,1 Jianjun Zhang,1 Mozhen Liu,2 Yuehong Liu1 1Department of Orthopedics, Peopleâs Hospital of Deyang City, Deyang, Peopleâs Republic of China; 2Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Yuehong Liu, Department of Orthopedics, Peopleâs Hospital of Deyang City, Deyang, Peopleâs Republic of China, Email doctorliuyuehong@163.comObjective: Widowed people have increased mortality than married people of the same age, a phenomenon known as the widowhood effect. This study aimed to investigate whether this effect exists in older patients with hip fracture.Methods: Using our own hip fracture database, a total of 1101 hip fracture patients were consecutively included from January 2014 to December 2021. Marital status was stratified as married (n = 793) and widowed (n = 308). Patients survival status was obtained from medical records or telephone follow-ups, and the outcomes were all-cause mortality at 30 days, 1 year and at latest follow-up. Univariate and multivariate Cox proportional hazard models were used to assess the association between marital status and mortality, and subgroup analyses according to sex were also conducted.Results: Compared with married patients, widowed patients were more likely to be older, female and intertrochanteric fracture, and were less likely to be urban area, smoking, drinking, and surgical treatment (P < 0.05). After a median follow-up of 37.1 months, the 30-day mortality was 4.3% (n = 47), 1-year mortality was 19.3% (n = 178), and total mortality was 34.2% (n = 376). Multivariate Cox analysis showed that widowed marital status remained an independent risk factor for 1-year mortality (HR = 1.437, 95% CI: 1.054â 1.959, P = 0.022), and total mortality (HR = 1.296, 95% CI: 1.038â 1.618, P = 0.022), whereas this association was not found in 30-day mortality (HR = 1.200, 95% CI: 0.607â 2.376, P = 0.599). Moreover, subgroup analyses also found that the widowhood effect on mortality was present in both male and female.Conclusion: Widowed marital status seems to be an independent risk factor for long-term mortality in older patients with hip fracture.Keywords: widowhood, mortality, hip fracture, older adults |
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