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Osteoporosis International

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01-03-2017 | Original Article

Excess mortality following hip fracture: impact of self-perceived health, smoking, and body mass index. A NOREPOS study

Authors: S. M. Solbakken, H. E. Meyer, H. Stigum, A. J. Søgaard, K. Holvik, J. H. Magnus, T. K. Omsland

Published in: Osteoporosis International | Issue 3/2017

Abstract

Summary

Self-perceived health, smoking, and body mass index measured years before the hip fracture predicted excess post-hip fracture mortality, and even hip fracture patients with the most favorable levels of these risk factors had higher mortality than subjects who did not fracture.

Introduction

This study aimed to investigate the impact of pre-fracture self-perceived health, smoking, and body mass index (BMI) on excess post-hip fracture mortality using matched peers without hip fracture as reference.

Methods

The study was based on the Cohort of Norway (CONOR) consisting of 10 regional health studies (1994–2003) and the NOREPOS hip fracture database (1994–2008). A matched cohort design was used to compare survival between hip fracture patients and subjects without fracture (matched on gender, age at participation in CONOR, and study site). Subjects aged ≥60 years were included. Hazard ratios were estimated using stratified Cox regression. Age-standardized mortality was also calculated.

Results

Overall, hip fracture patients (N = 3177) had a 2.26-fold (95 % CI 2.13, 2.40) increased mortality compared to matched subjects (N = 20,282). The highest excess mortality was found in hip fracture patients reporting poor health (HR 4.08, 95 % CI 3.17, 5.26) and daily smoking (HR 3.25, 95 % CI 2.89, 3.66) and in patients with BMI <18.5 (HR 3.07, 95 % CI 2.11, 4.47) prior to the fracture. However, excess mortality was also observed in hip fracture patients in all other categories of BMI, self-perceived health, and smoking.

Conclusions

Information on self-perceived health, smoking, and BMI collected years before hip fracture predicted excess post-hip fracture mortality, and even hip fracture patients with the most favorable levels of these risk factors had higher mortality than the matched subjects who did not fracture. This suggests that both pre-fracture health status and factors related to the hip fracture itself might affect post-hip fracture mortality.

Empana J-P, Dargent-Molina P, Bréart G, for the EG (2004) Effect of hip fracture on mortality in elderly women: the EPIDOS prospective study. J Am Geriatr Soc 52:685–690CrossRefPubMed

Farahmand B, Michaëlsson K, Ahlbom A, Ljunghall S, Baron J (2005) Survival after hip fracture. Osteoporos Int 16:1583–1590CrossRefPubMed

Forsén L, Søgaard AJ, Meyer HE, Edna TH, Kopjar B (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10:73–78CrossRefPubMed

Grønskag AB, Romundstad P, Forsmo S, Langhammer A, Schei B (2012) Excess mortality after hip fracture among elderly women in Norway. Osteoporos Int 23:1807–1811CrossRefPubMed

Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152:380–390CrossRefPubMedPubMedCentral

Hung L-W, Tseng W-J, Huang G-S, Lin J (2014) High short-term and long-term excess mortality in geriatric patients after hip fracture: a prospective cohort study in Taiwan. BMC Musculoskelet Disord 15:151–151CrossRefPubMedPubMedCentral

Omsland TK, Emaus N, Tell GS et al (2014) Mortality following the first hip fracture in Norwegian women and men (1999–2008). A NOREPOS study. Bone 63:81–86CrossRefPubMed

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521CrossRefPubMed

Hu F, Jiang C, Shen J, Tang P, Wang Y (2012) Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury 43:676–685CrossRefPubMed

10.

Kim S-M, Moon Y-W, Lim S-J, Yoon B-K, Min Y-K, Lee D-Y, Park Y-S (2012) Prediction of survival, second fracture, and functional recovery following the first hip fracture surgery in elderly patients. Bone 50:1343–1350CrossRefPubMed

11.

Kirkland LL, Kashiwagi DT, Burton MC, Cha S, Varkey P (2011) The Charlson comorbidity index score as a predictor of 30-day mortality after hip fracture surgery. Am J Med Qual 26:461–467CrossRefPubMed

12.

Schaller F, Sidelnikov E, Theiler R et al (2012) Mild to moderate cognitive impairment is a major risk factor for mortality and nursing home admission in the first year after hip fracture. Bone 51:347–352CrossRefPubMed

13.

Stewart NA, Chantrey J, Blankley SJ, Boulton C, Moran CG (2011) Predictors of 5 year survival following hip fracture. Injury 42:1253–1256CrossRefPubMed

14.

Söderqvist A, Ekström W, Ponzer S, Pettersson H, Cederholm T, Dalén N, Hedström M, Tidermark J (2009) Prediction of mortality in elderly patients with hip fractures: a two-year prospective study of 1,944 patients. Gerontology 55:496–504CrossRefPubMed

15.

Bliemel C, Sielski R, Doering B, Dodel R, Balzer-Geldsetzer M, Ruchholtz S, Buecking B (2016) Pre-fracture quality of life predicts 1-year survival in elderly patients with hip fracture—development of a new scoring system. Osteoporos Int 27:1979–1987CrossRefPubMed

16.

Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561CrossRefPubMed

17.

Tosteson ANA, Gottlieb DJ, Radley D, Fisher ES, Melton LJ (2007) Excess mortality following hip fracture: the role of underlying health status. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 18:1463–1472CrossRef

18.

Vestergaard P, Rejnmark L, Mosekilde L (2007) Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications. Osteoporos Int 18:1583–1593CrossRefPubMed

19.

Berger N, Van der Heyden J, Van Oyen H (2015) The global activity limitation indicator and self-rated health: two complementary predictors of mortality. Archives of Public Health 73:25CrossRefPubMedPubMedCentral

20.

DeSalvo K, Bloser N, Reynold K, He J, Muntner P (2006) Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med 21:267–275CrossRefPubMedPubMedCentral

21.

Idler E, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37CrossRefPubMed

22.

Singh-Manoux A, Gueguen A, Martikainen P, Ferre J, Marmot M, Shipley M (2007) Self-rated health and mortality: short-and long-term associations in the Whitehall II study. Psychosom Med 69:138–143CrossRefPubMedPubMedCentral

23.

Prieto-Alhambra D, Premaor MO, Avilés FF, Castro AS, Javaid MK, Nogués X, Arden NK, Cooper C, Compston JE, Diez-Perez A (2014) Relationship between mortality and BMI after fracture: a population-based study of men and women aged ≥40 Years. J Bone Miner Res 29:1737–1744CrossRefPubMed

24.

Naess O, Sogaard AJ, Arnesen E et al (2008) Cohort profile: cohort of Norway (CONOR). Int J Epidemiol 37:481–485CrossRefPubMed

25.

Omsland TK, Holvik K, Meyer HE et al (2012) Hip fractures in Norway 1999-2008: time trends in total incidence and second hip fracture rates: a NOREPOS study. Eur J Epidemiol 27:807–814CrossRefPubMed

26.

Cummings P, McKnight B, Greenland S (2003) Matched cohort methods for injury research. Epidemiol Rev 25:43–50CrossRefPubMed

27.

Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20:1633–1650CrossRefPubMed

28.

Brozek W, Reichardt B, Kimberger O, Zwerina J, Dimai H, Kritsch D, Klaushofer K, Zwettler E (2014) Mortality after hip fracture in Austria 2008–2011. Calcif Tissue Int 95:257–266CrossRefPubMed

29.

Meyer HE, Tverdal A, Falch JA, Pedersen JI (2000) Factors associated with mortality after hip fracture. Osteoporos Int 11:228–232CrossRefPubMed

30.

Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473CrossRefPubMed

31.

Lawrence VA, Hilsenbeck SG, Noveck H, Poses RM, Carson JL (2002) Medical complications and outcomes after hip fracture repair. Arch Intern Med 162:2053–2057CrossRefPubMed

32.

Roche JJW, Wenn RT, Sahota O, Moran CG (2005) Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ: British Medical Journal 331:1374–1374CrossRefPubMed

33.

Rosencher N, Vielpeau C, Emmerich J, Fagnani F, Samama CM (2005) Venous thromboembolism and mortality after hip fracture surgery: the ESCORTE study1,2. J Thromb Haemost 3:2006–2014CrossRefPubMed

34.

Moja L, Piatti A, Pecoraro V, Ricci C, Virgili G, Salanti G, Germagnoli L, Liberati A, Banfi G (2012) Timing matters in hip fracture surgery: patients operated within 48 Hours have better outcomes. A meta-analysis and meta-regression of over 190,000 patients. PLoS One 7:e46175CrossRefPubMedPubMedCentral

Title: Excess mortality following hip fracture: impact of self-perceived health, smoking, and body mass index. A NOREPOS study
Authors: S. M. Solbakken
H. E. Meyer
H. Stigum
A. J. Søgaard
K. Holvik
J. H. Magnus
T. K. Omsland
Publication date: 01-03-2017
Publisher: Springer London
Published in: Osteoporosis International / Issue 3/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-016-3795-0

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Excess mortality following hip fracture: impact of self-perceived health, smoking, and body mass index. A NOREPOS study

Abstract

Summary

Introduction

Methods

Results

Conclusions

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Abstract

Summary

Introduction

Methods

Results

Conclusions

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