{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:02:47Z","timestamp":1791302567563,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health, Italy, under the Ageing Network of Italian Research Hospitals (IRCCS)","award":["RCR-2020-23670069_001 SIRI"],"award-info":[{"award-number":["RCR-2020-23670069_001 SIRI"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Fractures of the femoral neck are one of the most common reasons for admission to an orthopedic institute. These patients also show multimorbidity (\u22652 chronic conditions) and polytherapy (\u22655 drugs). Multimorbidity and polytherapy are associated with a high risk of hospitalization and a reduction in quality of life. The present retrospective observational study was conducted to evaluate the prevalence of multimorbidity and polytherapy in patients aged \u226565 years and surgically treated for femoral neck fractures at an orthopedic institute over 3 years. Multimorbidity was evaluated with Elixhauser\u2019s comorbidity measure and polytherapy was obtained from the patient\u2019s medical record. This study identified 917 patients (84 \u00b1 7.6 years); most of them were females. Most patients presented \u22652 chronic conditions, the most frequent of which was uncomplicated hypertension, and most patients used \u22655 drugs, of which antithrombotic ones were the most frequently taken. No significant gender and age differences were found between the presence or not of multimorbidity or polytherapy. Multimorbidity and polytherapy were statistically associated with an increased and decreased risk of 1-year mortality, respectively. This retrospective study has evaluated the variables required for the establishment of a minimum core of descriptors of the prevalence of polytherapy and multimorbidity in the orthopedic field.<\/jats:p>","DOI":"10.3390\/jcm11216405","type":"journal-article","created":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T07:26:50Z","timestamp":1667114810000},"page":"6405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Multimorbidity and Polytherapy in Patients with Femoral Neck Fracture: A Retrospective Observational Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Veronica","family":"Borsari","sequence":"first","affiliation":[{"name":"Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Veronesi","sequence":"additional","affiliation":[{"name":"Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4534-6000","authenticated-orcid":false,"given":"Elisa","family":"Carretta","sequence":"additional","affiliation":[{"name":"Department of Programming and Monitoring, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Fini","sequence":"additional","affiliation":[{"name":"Scientific Direction, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,29]]},"reference":[{"key":"ref_1","unstructured":"European Union (2017). The 2018 Ageing Report: Underlying Assumptions & Projection Methodologies, European Commission, Directorate-General for Economic and Financial Affairs."},{"key":"ref_2","unstructured":"Statistica Research Department (2020, June 30). Share of Elderly Population in Italy 2009\u20132021. November 2021. Available online: https:\/\/www.statista.com\/statistics\/785104\/elderly-population-in-italy."},{"key":"ref_3","unstructured":"ISTAT (2020, June 30). Indicatori Demografici. Available online: https:\/\/www.istat.it\/it\/archivio\/269677."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11657-018-0423-y","article-title":"Decreasing trend of hip fractures incidence in Italy between 2007 and 2014: Epidemiological changes due to population aging","volume":"13","author":"Tarantino","year":"2018","journal-title":"Arch. Osteoporos."},{"key":"ref_5","first-page":"CD008165","article-title":"Interventions to improve the appropriate use of polypharmacy for older people","volume":"9","author":"Patterson","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2151459320916931","DOI":"10.1177\/2151459320916931","article-title":"Attitudes to Palliative Care in Patients with Neck-of-Femur Fracture-A Multicenter Survey","volume":"11","author":"Harries","year":"2020","journal-title":"Geriatr. Orthop. Surg. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s00198-016-3484-z","article-title":"Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: A cost analysis of a multicenter prospective study","volume":"27","author":"Burgers","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.injury.2020.01.032","article-title":"Posterior fully threaded positioning screw prevents femoral neck collapse in Garden I or II femoral neck fractures","volume":"51","author":"Shin","year":"2020","journal-title":"Injury"},{"key":"ref_9","unstructured":"The HIP ATTACK Investigators (2020). Accelerated surgery versus standard care in hip fracture (HIP ATTACK): An international, randomised, controlled trial. Lancet, 395, 698\u2013708."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/gerona\/gly110","article-title":"Frailty and multimorbidity: A systematic review and meta-analysis","volume":"74","author":"Vetrano","year":"2019","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jamda.2019.10.022","article-title":"Adverse Outcomes of Polypharmacy in Older People: Systematic Review of Reviews","volume":"21","author":"Davies","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_12","first-page":"1417","article-title":"Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization","volume":"72","author":"Vetrano","year":"2017","journal-title":"Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.jamda.2015.07.008","article-title":"Polypharmacy in Nursing Home Residents: What Is the Way Forward?","volume":"17","author":"Cherubini","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"6","author":"Fried","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"625","DOI":"10.14336\/AD.2020.0904","article-title":"The Impact of Frailty on Spine Surgery: Systematic Review on 10 years Clinical Studies","volume":"12","author":"Veronesi","year":"2021","journal-title":"Aging. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1007\/s12603-020-1518-x","article-title":"Can We Distinguish Age-Related Frailty from Frailty Related to Diseases? Data from the MAPT Study","volume":"24","author":"Angioni","year":"2020","journal-title":"J. Nutr. Health Aging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.2147\/TCRM.S272908","article-title":"The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population-Public Health Implications","volume":"16","author":"Rahman","year":"2020","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_18","first-page":"S131","article-title":"Comorbidity indices","volume":"32","author":"Dougados","year":"2014","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1111\/cts.13006","article-title":"Integrating real-world data and modeling to project changes in femoral neck bone mineral density and fracture risk in premenopausal women","volume":"14","author":"Beck","year":"2021","journal-title":"Clin. Transl. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wastesson, J.W., Minguez, A.C., Fastbom, J., Maioli, S., and Johnell, K. (2018). The composition of polypharmacy: A register-based study of Swedes aged 75 years and older. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0194892"},{"key":"ref_21","first-page":"107","article-title":"Gender differences in cognitive decline in centenarians and the oldest old","volume":"6","author":"Bientinesi","year":"2020","journal-title":"Ital. J. Gender-Specific Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Pellikaan, P., Giarmatzis, G., Sloten, J.V., Verschueren, S., and Jonkers, I. (2018). Ranking of osteogenic potential of physical exercises in postmenopausal women based on femoral neck strains. PLoS One, 13.","DOI":"10.1371\/journal.pone.0195463"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.1111\/jocn.15883","article-title":"Can emergency nurses safely and effectively insert fascia iliaca blocks in patients with a fractured neck of femur? A prospective cohort study in an Australian emergency department","volume":"30","author":"Gawthorne","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3225","DOI":"10.3390\/jcm10153225","article-title":"Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study","volume":"10","author":"Garu","year":"2021","journal-title":"J. Clin. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/epirev\/mxs009","article-title":"Multimorbidity in older adults","volume":"35","author":"Salive","year":"2013","journal-title":"Epidemiol. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00198-016-3803-4","article-title":"Pre-fracture individual characteristics associated with high total health care costs after hip fracture","volume":"28","author":"Schousboe","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1002\/jbmr.2836","article-title":"Osteoporotic Fractures in Men (MrOS) Study Research Group. Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS)","volume":"31","author":"Cauley","year":"2016","journal-title":"J. Bone Miner. Res."},{"key":"ref_28","first-page":"62","article-title":"Multimorbidity epidemiology and health care utilization through combined healthcare administrative databases","volume":"45","author":"Fortuna","year":"2021","journal-title":"Epidemiol. Prev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1007\/s00198-017-4050-z","article-title":"Meta-analysis of hypertension and osteoporotic fracture risk in women and men","volume":"28","author":"Li","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_30","first-page":"16","article-title":"The Current and Future Challenges of Hip Fracture Management in Malaysia","volume":"4","author":"Ong","year":"2020","journal-title":"Malays. Orthop. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40001-019-0362-0","article-title":"Orthogeriatric treatment reduces potential inappropriate medication in older trauma patients: A retrospective, dual-center study comparing conventional trauma care and co-managed treatment","volume":"24","author":"Gleich","year":"2019","journal-title":"Eur. J. Med. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10195-012-0214-y","article-title":"II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: Arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery","volume":"14","author":"Randelli","year":"2013","journal-title":"J. Orthop. Traumatol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Thorell, K., Ranstad, K., Midl\u00f6v, P., Borgquist, L., and Halling, A. (2014). Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: A cohort study. BMC Geriatr., 14.","DOI":"10.1186\/1471-2318-14-131"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"54","DOI":"10.3390\/nursrep11010006","article-title":"Gender Differences in Factors Affecting Life Satisfaction of the Elderly with Multimorbidity in Korea","volume":"11","author":"Kim","year":"2021","journal-title":"Nurs. Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/21\/6405\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:05:30Z","timestamp":1760144730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/21\/6405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,29]]},"references-count":34,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["jcm11216405"],"URL":"https:\/\/doi.org\/10.3390\/jcm11216405","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,29]]}}}