{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:39:46Z","timestamp":1760834386676,"version":"build-2065373602"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Innovation the Talent Promotion Plan of Shaanxi Province","award":["2024RS-CXTD-86"],"award-info":[{"award-number":["2024RS-CXTD-86"]}]},{"name":"Foundation of Xi\u2019an Municipal Health","award":["2024ms15"],"award-info":[{"award-number":["2024ms15"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,9]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the association between heart rate on admission and mortality in elderly patients with hip fractures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>At a trauma centre in northwestern China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Elderly patients with hip fractures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This cohort study included 2006 patients who met the study criteria. The mean heart rate at admission was 81.77\u00b115.63\u2009beats per minute. During follow-up, 189 patients died for all-cause reasons in 1 year. Age, coronary heart disease, cancer, dementia and time to operation were introduced in multivariate regression analysis. Multivariate logistic regression showed that heart rate was associated with mortality in geriatric patients with hip fracture (OR=1.01, 95% CI 1.00 to 1.02, p=0.0242). However, the linear association was unstable, and we found a nonlinear one. In the nonlinear association, the inflection point was 84 beats per minute. If below this threshold, each 1 beat per minute increase in heart rate was associated with a 4% increase in the risk of death (OR=1.04, 95% CI 1.01 to 1.06, p=0.0017). If greater than this threshold, the risk of death peaked and was not associated with the heart rate (OR=1.00, 95% CI 0.98 to 1.01, p=0.6691).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In conclusion, the heart rate was nonlinearly associated with 1-year mortality in geriatric patients with hip fractures. The low heart rate on admission was associated with low 1-year mortality. When the heart rate was over 84 beats per minute, the risk of death peaked, and there was no association with heart rate anymore.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>This study was registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093662","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T12:06:46Z","timestamp":1736338006000},"page":"e093662","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["The heart rate on admission was associated with the mortality in elderly patients with hip fractures: a retrospective cohort study from a trauma centre in northwestern China"],"prefix":"10.1136","volume":"15","author":[{"given":"Wei-Song","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao-Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1135-6972","authenticated-orcid":false,"given":"Bin-Fei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"2025101814003868000_15.1.e093662.1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.6061\/clinics\/2012(06)02","article-title":"Early interdisciplinary hospital intervention for elderly patients with hip fractures\u202f: functional outcome and mortality","volume":"67","author":"Tarazona-Santabalbina","year":"2012","journal-title":"Clinics (Sao Paulo)"},{"key":"2025101814003868000_15.1.e093662.2","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/S0140-6736(98)09075-8","article-title":"Mortality after all major types of osteoporotic fracture in men and women: an observational study","volume":"353","author":"Center","year":"1999","journal-title":"The Lancet"},{"key":"2025101814003868000_15.1.e093662.3","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/s11420-017-9561-9","article-title":"The Incidence of Perioperative Cardiac Events after Orthopedic Surgery: A Single Institutional Experience of Cases Performed over One Year","volume":"13","author":"Urban","year":"2017","journal-title":"HSS J"},{"key":"2025101814003868000_15.1.e093662.4","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000287654.49358.3a"},{"key":"2025101814003868000_15.1.e093662.5","doi-asserted-by":"crossref","first-page":"755","DOI":"10.2147\/CIA.S250620","article-title":"Prediction of Early Postoperative Major Cardiac Events and In-Hospital Mortality in Elderly Hip Fracture Patients: The Role of Different Types of Preoperative Cardiac Abnormalities on Echocardiography Report","volume":"15","author":"Chen","year":"2020","journal-title":"Clin Interv Aging"},{"key":"2025101814003868000_15.1.e093662.6","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.injury.2020.01.004","article-title":"Effect of heart failure on postoperative short and long-term mortality in elderly patients with hip fracture","volume":"51","author":"Cha","year":"2020","journal-title":"Injury"},{"key":"2025101814003868000_15.1.e093662.7","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1159\/000513450","article-title":"Atrial Fibrillation and Mortality in the Oldest Old after Surgery for Hip Fractures","volume":"67","author":"Frenkel","year":"2021","journal-title":"Gerontology"},{"key":"2025101814003868000_15.1.e093662.8","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1590\/1806-9282.20210686","article-title":"Atrial fibrillation as a preoperative risk factor predicts long-term mortality in elderly patients without heart failure and undergoing hip fracture surgery","volume":"67","author":"Orhan","year":"2021","journal-title":"Rev Assoc Med Bras"},{"key":"2025101814003868000_15.1.e093662.9","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2020-138679"},{"key":"2025101814003868000_15.1.e093662.10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.repc.2015.07.010","article-title":"Validity of the updated GRACE risk predictor (version 2.0) in patients with non-ST-elevation acute coronary syndrome","volume":"35","author":"Akyuz","year":"2016","journal-title":"Rev Port Cardiol"},{"key":"2025101814003868000_15.1.e093662.11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2002.50110.x"},{"key":"2025101814003868000_15.1.e093662.12","doi-asserted-by":"crossref","first-page":"7699","DOI":"10.2147\/IJGM.S333971","article-title":"Admission Resting Heart Rate as an Independent Predictor of All-Cause Mortality in Elderly Patients with Hip Fracture","volume":"Volume 14","author":"Wang","year":"2021","journal-title":"IJGM"},{"key":"2025101814003868000_15.1.e093662.13","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jamda.2023.08.004","article-title":"Preoperative Serum Calcium Level Predicts Postoperative Mortality in Older Adult Patients with Hip Fracture: A Prospective Cohort Study of 2333 Patients","volume":"25","author":"Li","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"2025101814003868000_15.1.e093662.14","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313519932"},{"key":"2025101814003868000_15.1.e093662.15","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1007\/s00392-020-01714-w","article-title":"The impact of time-updated resting heart rate on cause-specific mortality in a random middle-aged male population: a lifetime follow-up","volume":"110","author":"Cui","year":"2021","journal-title":"Clin Res Cardiol"},{"key":"2025101814003868000_15.1.e093662.16","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(90)90004-N"},{"key":"2025101814003868000_15.1.e093662.17","doi-asserted-by":"publisher","DOI":"10.1017\/S004857720199225X"},{"key":"2025101814003868000_15.1.e093662.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011858"},{"key":"2025101814003868000_15.1.e093662.19","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s10654-017-0312-5","article-title":"Physical activity and the risk of hip fracture in the elderly: a prospective cohort study","volume":"32","author":"Lagerros","year":"2017","journal-title":"Eur J Epidemiol"},{"key":"2025101814003868000_15.1.e093662.20","first-page":"71","article-title":"Cardiac Vagus and Exercise","volume":"34","author":"Gourine","year":"2019","journal-title":"Physiol (Bethesda)"},{"key":"2025101814003868000_15.1.e093662.21","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.5.621"},{"key":"2025101814003868000_15.1.e093662.22","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1213\/ANE.0000000000005659","article-title":"Beta-Blocker Therapy Is Associated With Increased 1-Year Survival After Hip Fracture Surgery: A Retrospective Cohort Study","volume":"133","author":"Mohammad Ismail","year":"2021","journal-title":"Anesth Analg"},{"key":"2025101814003868000_15.1.e093662.23","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.jos.2022.01.009","article-title":"Analysis of the risk factors of mortality in elderly patients with hip fracture using a combined database of medical and long-term care insurance claims data","volume":"28","author":"Takagi","year":"2023","journal-title":"J Orthop Sci"},{"key":"2025101814003868000_15.1.e093662.24","doi-asserted-by":"crossref","first-page":"493","DOI":"10.5152\/j.aott.2021.21004","article-title":"Analysis of risk factors affecting mortality in elderly patients operated on for hip fractures: A retrospective comparative study","volume":"55","author":"Bi\u00e7en","year":"2021","journal-title":"Acta Orthop Traumatol Turc"},{"key":"2025101814003868000_15.1.e093662.25","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afab233","article-title":"Development and validation of a model for predicting mortality in patients with hip fracture","volume":"51","author":"Hjelholt","year":"2022","journal-title":"Age Ageing"},{"key":"2025101814003868000_15.1.e093662.26","first-page":"467","article-title":"Predictors of Prolonged Hospitalization and In-Hospital Mortality After Hip Fracture: A Retrospective Study on Discharge Registry","volume":"34","author":"Di Giovanni","year":"2022","journal-title":"Ann Ig"},{"key":"2025101814003868000_15.1.e093662.27","doi-asserted-by":"crossref","unstructured":"Chiang M-H , Lee H-J , Kuo Y-J , et al . Predictors of In-Hospital Mortality in Older Adults Undergoing Hip Fracture Surgery: A Case-Control Study. Geriatr Orthop Surg Rehabil 2021;12. doi:10.1177\/21514593211044644","DOI":"10.1177\/21514593211044644"},{"key":"2025101814003868000_15.1.e093662.28","doi-asserted-by":"crossref","DOI":"10.1177\/21514593211037758","article-title":"The Association of On-Admission Blood Hemoglobin, C-Reactive Protein, and Serum Creatinine With 2-Year Mortality of Patients With Femoral Neck Fractures","volume":"12","author":"Sayed-Noor","year":"2021","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"2025101814003868000_15.1.e093662.29","doi-asserted-by":"crossref","DOI":"10.1177\/21514593211036252","article-title":"Higher Charlson Comorbidity Index Increases 90-Day Readmission Rate with Poorer Functional Outcomes in Surgically Treated Hip Fracture Patients","volume":"12","author":"Gatot","year":"2021","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"2025101814003868000_15.1.e093662.30","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1007\/s00198-021-06023-0","article-title":"Excess mortality after hip fracture: fracture or pre-fall comorbidity?","volume":"32","author":"Liow","year":"2021","journal-title":"Osteoporos Int"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-093662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:00:46Z","timestamp":1760821246000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-093662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,8]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bmjopen-2024-093662"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-093662","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}