Epidemiological characteristics and outcome in elderly patients sustaining non‐simultaneous bilateral hip fracture: A systematic review and meta‐analysis
Bibliographic record
Abstract
OBJECTIVES: The present study aimed to quantitatively and comprehensively conclude the epidemiological characteristics and outcome in elderly patients with non-simultaneous bilateral hip fractures. METHODS: A search was applied to Medline, Embase and Cochrane central database (all up to February 2014). All the studies on non-simultaneous bilateral hip fractures in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. All the data were carefully and independently abstracted by two reviewers, any disagreement was settled by discussion. Data were pooled and a meta-analysis completed. RESULTS: A total of 23 studies (all were observational) including 2168 cases with bilateral hip fractures were identified, showing an accumulated incidence of 8.54%, and of them 71.4% were symmetrical. A total of 70.4% of cases occurred in the first 3 years, especially 36.3% in the first year. Results of meta-analyses showed that patients of female sex (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.10-1.99), advanced age (standardized mean difference 0.25, 95% CI 0.15-0.36), initial trochanteric fractures (OR 1.15, 95% CI 1.01-1.32) and osteoporosis (Singh Index 1-3) (OR 10.02, 95% CI 5.41-18.57) were more likely to sustain a second contralateral hip fracture. CONCLUSIONS: Non-simultaneous bilateral hip fracture accounts for a high proportion of hip fractures, and most of the second hip fractures occurred in the first 3 years. Patients of female sex, having initial trochanteric fractures, of more advanced age and having osteoporosis are more likely to sustain a second contralateral hip fracture, and risk-reduction strategies should be implemented.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.027 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".