Unveiling unique clinical phenotypes of hip fracture patients and the temporal association with cardiovascular events

Warrington W. Q. Hsu, Xiaowen Zhang, Chor-Wing Sing, Kathryn C. B. Tan, Ian Chi-Kei Wong, Wallis C. Y. Lau and Ching-Lung Cheung ()
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Warrington W. Q. Hsu: The University of Hong Kong
Xiaowen Zhang: The University of Hong Kong
Chor-Wing Sing: The University of Hong Kong
Kathryn C. B. Tan: The University of Hong Kong
Ian Chi-Kei Wong: The University of Hong Kong
Wallis C. Y. Lau: The University of Hong Kong
Ching-Lung Cheung: The University of Hong Kong

Nature Communications, 2024, vol. 15, issue 1, 1-12

Abstract: Abstract Cardiovascular events are the leading cause of death among hip fracture patients. This study aims to identify subphenotypes of hip fracture patients and investigate their association with incident cardiovascular events, all-cause mortality, and health service utilisation in Hong Kong and the United Kingdom populations. By the latent class analysis, we show three distinct clusters in the Hong Kong cohort (n = 78,417): Cluster 1 has cerebrovascular and hypertensive diseases, hyperlipidemia, and diabetes; Cluster 2 has congestive heart failure; Cluster 3 consists of relatively healthy patients. Compared to Cluster 3, higher risks of major adverse cardiovascular events are observed in Cluster 1 (hazard ratio 1.97, 95% CI 1.83 to 2.12) and Cluster 2 (hazard ratio 4.06, 95% CI 3.78 to 4.35). Clusters 1 and 2 are also associated with a higher risk of mortality, more unplanned accident and emergency visits and longer hospital stays. Self-controlled case series analysis shows a significantly elevated risk of major adverse cardiovascular events within 60 days post-hip fracture. Similar associations are observed in the United Kingdom cohort (n = 27,948). Pre-existing heart failure is identified as a unique subphenotype associated with poor prognosis after hip fractures.

Date: 2024
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DOI: 10.1038/s41467-024-48713-3

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