Centenarians with proximal humeral fracture

TL;DR

This study examines the treatment and outcomes of proximal humeral fractures in German centenarians, finding high mortality and a preference for non-surgical treatment.

Contribution

The study provides the first detailed analysis of proximal humeral fractures in centenarians using nationwide claims data.

Findings

Centenarians with PHF were more often female and had more comorbidities but fewer lifestyle risk factors.

Surgical treatment was less common in centenarians compared to younger patients.

Approximately 59.2% of centenarians died within one year of sustaining a PHF.

Abstract

The demographic change in Germany leads to an increased number of centenarians. Within this population fragility fractures, such as the proximal humeral fracture (PHF), are not well investigated. This study aims to evaluate the epidemiology, treatment and outcome after a PHF in patients ≥ 100 years of age in Germany.

Retrospective claims data of the BARMER health insurance were analyzed. All in- and outpatient cases of insurance holders ≥ 65 years from 01/2011 to 09/2022, with coded diagnosis of PHF were analyzed. The patients aged 65–99 years were used as a comparison group for the centenarians. Primary endpoints were overall survival, major adverse events (MAEs) and thrombo-embolic events.

In total, 100,482 patients with PHF were included in the study, with 230 aged 100 years and older. Centenarians with a PHF were more often female with several age-associated comorbidities, but less life-style associated risk factors. Centenarians were less often treated surgically. The outcome after PHF was worse with increasing age, 59.2% of the centenarians died one year after the PHF.

The majority of centenarians sustaining a proximal humeral fracture was female. The most common treatment was the non-operative therapy. Nevertheless, also the operative therapy is associated with a low complication rate. As expected, the mortality rate is high, with almost 60% of deceased patients after one year. It remains unclear, if the mortality was related to proximal humeral fractures.

Level III, retrospective comparative study.

The online version contains supplementary material available at 10.1186/s12877-025-06820-w.

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