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Incidence and outcomes of humeral fractures in the older person

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Abstract

Summary

Humeral fractures are not well understood and thus we examined the incidence and outcomes of elderly humeral fractures at a single institution over a 3-year period. We found increasing incidence in humeral fractures with increasing age and negative outcomes comparable to hip fractures.

Introduction

In this study, we report the incidence of humeral fractures in the older patient and their outcomes, including new nursing homes discharges and mortality, residing in the metropolitan referral area of a Sydney tertiary referral hospital.

Methods

All admissions between 2013 and 2016, of patients aged 65 years or more, presenting to hospital with humeral fractures were reviewed. The data was explored primarily for outcomes (mortality and new admissions to residential aged care facility) and secondarily for clinical association with humeral fractures.

Results

Two hundred eighty-one episodes of humeral fracture were identified. Incidence peaked in the above 85-year-old group at 670 per 100,000 persons per year. Proximal fractures were accounted for 84.3% of the cohort. 12.8% received operative management. The in-hospital mortality rate was 3.6%. Gender was a significant predictor for mortality (OR = 5.8, 95% CI 1.3–28.5, p value = 0.0032) with males six times more likely to experience in-hospital mortality compared to females. 17.8% of participants were admitted to a new nursing home. Logistical regression demonstrated age (OR = 1.10, 95% CI 1.04–1.17; p value = 0.001) and Charlson comorbidity index (OR = 1.32, 95% CI 1.04–1.66; p value = 0.02) were predictors of admission to a new nursing home.

Conclusion

Humeral fractures are common in the older population and cause a substantial amount of new nursing home admissions and mortality. Further study is required to ascertain appropriate guidelines for treatment and rehabilitation.

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Acknowledgements

I thank the members of the medical record departments of Calvary Rehabilitation, St George Public, St George Private, President Private, Waratah Private, Kareena Private, Wollongong Public, Woy Woy Private, and Sutherland Public Hospitals for their assistance in data collection.

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Authors and Affiliations

  1. Department of Aged Care, St George Hospital, St George Hospital, 3 Chapel Street Kogarah NSW, Sydney, 2217, Australia

    M. Q. Wang, T. Youssef & P. Smerdely

  2. School of Public Health and Community Medicine, University of NSW, Sydney, Australia

    P. Smerdely

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  1. M. Q. Wang
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Correspondence to M. Q. Wang.

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Wang, M.Q., Youssef, T. & Smerdely, P. Incidence and outcomes of humeral fractures in the older person. Osteoporos Int 29, 1601–1608 (2018). https://doi.org/10.1007/s00198-018-4500-2

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  • DOI: https://doi.org/10.1007/s00198-018-4500-2

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