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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

Mortality after osteoporotic hip fracture: incidence, trends, and associated factors

Authors: Olalla Guzon-Illescas, Elia Perez Fernandez, Natalia Crespí Villarias, Francisco Javier Quirós Donate, Marina Peña, Carlos Alonso-Blas, Alberto García-Vadillo, Ramon Mazzucchelli

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Background

It is known that mortality after hip fracture increases compared to the general population; the trend in mortality is a controversial issue.
The objective of this study is to examine incidence, trends, and factors associated with mortality in patients with osteoporotic hip fractures.

Methods

This is a retrospective cohort study that uses the Registry for Hospital Discharges of the National Health System of our hospital. Patients older than 45 having an osteoporotic hip fracture between 1999 and 2015 were identified. Demographic data and comorbidities were obtained. A survival analysis was performed (Cox regression and Kaplan-Meier). Incidence rate, standardized death rate (SDR), trend (Poisson regression), and risk (hazard ratio) were calculated.

Results

During 1999–2015, in our hospital, there were a total of 3992 patients admitted due to osteoporotic hip fracture. Out of these 3992 patients, 3109 patients (77.9%) were women with an average age of 84.47 years (SD 8.45) and 803 (22.1%) were men with an average age of 81.64 years (SD 10.08). The cumulative incidence of mortality was 69.38%. The cumulative mortality rate for 12 months was 33%. The annual mortality was 144.9/1000 patients/year. The 1-year mortality rate increased significantly by 2% per year (IRR 1.020, CI95% 1.008–1.033). The median overall survival was 886 days (CI95% 836–951). The probability of mortality density for a period of 10 years following a hip fracture was 16% for women and 25% for men (first 90 days). The SDR was 8.3 (CI95% 7.98–8.59). Variables that showed statistically significant association with mortality were aged over 75, masculine, institutionalization, mild to severe liver disease, chronic kidney disease, COPD, dementia, heart failure, diabetes, the Charlson Index > 2 , presence of vision disorders and hearing impairment, incontinence, and Downton scale.

Conclusions

For the last 17 years, an increase of mortality for patients with hip fracture and a higher mortality rate in men than in women were observed. Institutionalization combined with comorbidities is associated with a higher mortality.
Appendix
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Literature
1.
O’Neill TW, Roy DK. How many people develop fractures with what outcome? Best Pract Res Clin Rheumatol. 2005;19:879–8955.CrossRef
2.
Cree M, Soskolne CL, Belseck E, Hornig J, McElhaney JE, Brant R, Suarez-Almazor M. Mortality and institutionalization following hip fracture. J Am Geriatr Soc. 2000;48:283–8.CrossRef
3.
Tarazona-Santabalbina FJ, Belenguer-Varea A, Rovira-Daudi E, Salcedo-Mahiques E, Cuesta-Peredó D, Doménech-Pascual JR, Salvador-Pérez MI, Avellana-Zaragoza JA. Early interdisciplinary hospital intervention for elderly patients with hip fractures: functional outcome and mortality. Clinics (Sao Paulo). 2012;67(6):547–56.CrossRef
4.
Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999;353(9156):878–82.CrossRef
5.
Browner WS, Pressman AR, Nevitt MC, Cummings SR. Mortality following fractures in older women. The study of osteoporotic fractures. Arch Intern Med. 1996;156(14):1521–5.CrossRef
6.
Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761–7.CrossRef
7.
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK. The components of excess mortality after hip fracture. Bone. 2003;32(5):468–73.CrossRef
8.
Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int. 2009;20(10):1633–50.CrossRef
9.
Kannegaard PN, van der Mark S, Eiken P, Abrahamsen B. Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing. 2010;39(2):203–9.CrossRef
10.
Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, et al. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152(6):380–90.CrossRef
11.
Omsland TK, Emaus N, Tell GS, Magnus JH, Ahmed LA, Holvik K, et al. Mortality following the first hip fracture in Norwegian women and men (1999-2008). A NOREPOS study. Bone. 2014;63:81–6.CrossRef
12.
Hu F, Jiang C, Shen J, Tang P, Wang Y. Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury. 2012;43(6):676–85.CrossRef
13.
L Riska BS, Forsén L, Omsland TK, Søgaard AJ, Meyer HE, Holvik K. Does the association of comorbidity with 1-year mortality after hip fracture differ according to gender? The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). J Am Geriatr Soc. 2018;66(3):553–8.CrossRef
14.
Ha Y, Park Y, Nam KW, Kim S. Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci. 2015;30(4):483–8.CrossRef
15.
Ariza-Vega P, Kristensen MT, Martín-Martín L, Jiménez-Moleón JJ. Predictors of long-term mortality in older people with hip fracture. Arch Phys Med Rehabil. 2015;96(7):1215–21.CrossRef
16.
Menéndez-Colino R, Alarcon T, Gotor P, Queipo R, Ramírez-Martín R, Otero A, et al. Baseline and pre-operative 1-year mortality risk factors in a cohort of 509 hip fracture patients consecutively admitted to a co-managed orthogeriatric unit (FONDA Cohort). Injury. 2018.
17.
Jacobs H, Zeeb H, Hoffmann F. Incidence rates of and mortality after hip fracture among German nursing home residents. Int J Environ Res Public Health. 2018;15:2.CrossRef
18.
Ireland AW, Kelly PJ, Cumming RG. Associations between hospital-based rehabilitation for hip fracture and two-year outcomes for mortality and independent living: an Australian database study of 1724 elderly community-dwelling patients. J Rehabil Med. 2016;48(7):625–31.CrossRef
19.
Mazzucchelli R, Pérez-Fernández E, Crespí N, García-Vadillo A, Rodriguez Caravaca G, Gil de Miguel A, et al. Second hip fracture: incidence, trends, and predictors. Calcif Tissue Int. 2017.
20.
Yoon H, Park C, Jang S, Jang S, Lee Y, Ha Y. Incidence and mortality following hip fracture in Korea. J Korean Med Sci. 2011;26(8):1087–92.CrossRef
21.
Vestergaard P, Rejnmark L, Mosekilde L. Has mortality after a hip fracture increased? J Am Geriatr Soc. 2007;55(11):1720–6.CrossRef
22.
Bliuc D, Milch VE, Nguyen TV, et al. Mortality risk associated with low-trauma Osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301:513–21.CrossRef
23.
Huntjens KM, Kosar S, van Geel TA, et al. Risk of subsequent fracture and mortality within a period of 5 years after a non-vertebral fracture. Osteoporos Int. 2010;21:2075–82.CrossRef
24.
Johnell O, Kanis JA, Oden A, et al. Fracture risk following an osteoporotic fracture. Osteoporos Int. 2004;15:175–9.CrossRef
25.
Piirtola M, Vahlberg T, Lopponen M, Raiha I, et al. Fractures as predictors of excess mortality in the aged – a population-based study with a 12-year followup. Eur J Epidemiol. 2008;23:747–55.CrossRef
26.
Melton LJ 3rd, Achenbach SJ, Atkinson EJ, et al. Long-term mortality following fractures at different skeletal sites: a population-based cohort study. Osteoporos Int. 2013;24:1689–96.CrossRef
27.
Somersalo A, Paloneva J, Kautiainen H, et al. Increased mortality after upper extremity fracture requiring inpatient care. Acta Orthop. 2015;86:533–57.CrossRef
28.
Karlsson MK, Hasserius R, Obrant KJ. Individuals who sustain nonosteoporotic fractures continue to also sustain fragility fractures. Calcif Tissue Int. 1993;53(4):229–31.CrossRef
29.
Karampampa K, Ahlbom A, Michaëlsson K, Andersson T, Drefahl S, Modig K. Declining incidence trends for hip fractures have not been accompanied by improvements in lifetime risk or post-fracture survival--a nationwide study of the Swedish population aged 60 years and older. Bone. 2015;78:55–61.CrossRef
30.
Chau PH, Wong M, Lee A, Ling M, Woo J. Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09. Age Ageing. 2013;42(2):229–33.CrossRef
31.
Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302(14):1573–9.CrossRef
32.
Finnes TE, Meyer HE, Falch JA, Medhus AW, Wentzel-Larsen T, Lofthus CM. Secular reduction of excess mortality in hip fracture patients >85 years. BMC Geriatr. 2013;13:25.CrossRef
33.
Sullivan KJ, Husak LE, Altebarmakian M, Brox WT. Demographic factors in hip fracture incidence and mortality rates in California, 2000-2011. J Orthop Surg Res. 2016;11:4.CrossRef
34.
Leslie WD, O'Donnell S, Jean S, Lagacé C, Walsh P, Bancej C, et al. Trends in hip fracture rates in Canada. JAMA. 2009;302(8):883–9.CrossRef
35.
Orces CH, Alamgir AH. Trends in hip fracture-related mortality in Texas, 1990-2007. South Med J. 2011;104(7):482–7.CrossRef
36.
Medin E, Goude F, Melberg HO, Tediosi F, Belicza E, Peltola M. European regional differences in all-cause mortality and length of stay for patients with hip fracture. Health Econ. 2015;24(Suppl 2):53–64.CrossRef
37.
Mazzucchelli Esteban R, Pérez-Fernández E, Crespí-Villarías N, García-Vadillo A, Rodriguez-Caravaca G, Gil de Miguel A, et al. Trends in osteoporotic hip fracture epidemiology over a 17-year period in a Spanish population: Alcorcón 1999-2015. Arch Osteoporos. 2017;12(1):84.CrossRef
38.
Forsén L, Sogaard AJ, Meyer HE, et al. Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int. 1999;10:73–8.CrossRef
39.
Johnell O, Kanis JA, Odén A, et al. Mortality after osteoporotic fractures. Osteoporos Int. 2004;15:38–42.CrossRef
40.
Fransen M, Woodward M, Norton R, et al. Excess mortality or institutionalization after hip fracture: men are at greater risk than women. J Am Geriatr Soc. 2002;50:685–90.CrossRef
Metadata
Title
Mortality after osteoporotic hip fracture: incidence, trends, and associated factors
Authors
Olalla Guzon-Illescas
Elia Perez Fernandez
Natalia Crespí Villarias
Francisco Javier Quirós Donate
Marina Peña
Carlos Alonso-Blas
Alberto García-Vadillo
Ramon Mazzucchelli
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1226-6

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