Similar mortality rates in hip fracture patients over the past 31 years
Bibliographic record
Abstract
BACKGROUND: Over 320,000 hip fractures occur in North America each year and they are associated with a mortality rate ranging from 14% to 36% within 1 year of surgery. We assessed whether mortality and reoperation rates have improved in hip fracture patients over the past 31 years. METHODS: 3 electronic databases were searched for randomized controlled trials on hip fracture management, published between 1950 and 2013. Articles that assessed the surgical treatment of intertrochanteric or femoral neck fractures and measured mortality and/or reoperation rates were obtained. We analyzed overall mortality and reoperation rates, as well as mortality rates by fracture type, comparing mean values in different decades. Our primary outcome was the change in 1-year postoperative mortality. RESULTS: 70 trials published between 1981 and 2012 were included in the review. Overall, the mean 1-year mortality rate changed from 24% in the 1980s to 23% in the 1990s, and to 21% after 1999 (p = 0.7). 1-year mean mortality rates for intertrochanteric fractures diminished from 34% to 23% in studies published before 2000 and after 1999 (p = 0.005). Mean mortality rates for femoral neck fractures were similar over time (~20%). Reoperation rates were also similar over time. INTERPRETATION: We found similar mortality and reoperation rates in surgically treated hip fracture patients over time, with the exception of decreasing mortality rates in patients with intertrochanteric fractures.
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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 | 0.008 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 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".