Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2017

01-12-2017 | Original Article

Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study

Authors: Reidar P. Lystad, Cate M. Cameron, Rebecca J. Mitchell

Published in: Archives of Osteoporosis | Issue 1/2017

Login to get access

Abstract

Summary

With an ageing population, the burden of hip fractures is expected to increase in the coming decades. Older individuals with hip fracture are more than 3.5 times more likely to die within 12 months compared to non-injured individuals. The main priority for reducing mortality should be prevention of hip fracture.

Purpose

The aim of this study is to quantify and describe the 12-month mortality of older persons presenting to hospitals in Australia with a hip fracture.

Methods

Population-based matched cohort study using linked hospital and mortality data from four Australian states (New South Wales, Queensland, South Australia, and Tasmania). Individuals aged 65 years and older who had a hospital admission with a primary diagnosis of hip fracture in 2009 (n = 9748) and a matched comparison cohort of non-injured individual were selected from the electoral roll (n = 9748). The comparison group was matched 1:1 on age, sex, and postcode of residence. Adjusted mortality rate ratios (MRR) and attributable risk percent were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival.

Results

The hip fracture cohort experienced significantly worse survival at the 12-month post-fracture hospitalisation (P < 0.0001). Individuals with hip fracture were more than 3.5 times more likely to die within 12 months compared to their non-injured counterparts (MRR 3.62 [95%CI 3.23–4.05]). Hip fracture was likely to be a contributory factor in 72% of mortality within 12 months after the index hospital admission. Excess mortality risk at 12 months was higher in males than that in females and in the 65–74-year age group.

Conclusions

With an ageing population in Australia, the burden of hip fractures is expected to increase in the coming decades. Because incident hip fracture is the main predictor of subsequent mortality, the main priority for reducing excess mortality after hip fracture is primary and secondary prevention of hip fracture.
Appendix
Available only for authorised users
Literature
1.
Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902CrossRefPubMed
2.
Kanis JA, Oden A, EV MC, Johansson H, Wahl DA, Cooper C, IOF Working Group on Epidemiology and Quality of Life (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256CrossRefPubMedPubMedCentral
3.
Haentjens P, Magaziner J, Colon-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
4.
Katsoulis M, Benetou V, Karapetyan T, Feskanich D, Grodstein F, Pettersson-Kymmer U, Eriksson S, Wilsgaard T, Jørgensen L, Ahmed LA, Schöttker B, Brenner H, Bellavia A, Wolk A, Kubinova R, Stegeman B, Bobak M, Boffetta P, Trichopoulou A (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med 281:300–310CrossRefPubMed
5.
Stephens AS, Toson B, Close JC (2014) Current and future burden of incident hip fractures in New South Wales, Australia. Arch Osteoporos 9:200CrossRefPubMed
6.
Budhia S, Mikyas Y, Tang M, Badamgarav E (2012) Osteoporotic fractures: a systematic review of U.S. healthcare costs and resource utilization. PharmacoEconomics 30:147–170CrossRefPubMed
7.
Haentjens P, Autier P, Barette M, Boonen S, Belgian Hip Fracture Study Group (2001) The economic cost of hip fractures among elderly women. A one-year, prospective, observational cohort study with matched-pair analysis. Belgian Hip Fracture Study Group. J Bone Joint Surg Am 83-A:493–500CrossRefPubMed
8.
Haentjens P, Lamraski G, Boonen S (2005) Costs and consequences of hip fracture occurrence in old age: an economic perspective. Disabil Rehabil 27:1129–1141CrossRefPubMed
9.
Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–370CrossRefPubMed
10.
Nurmi I, Narinen A, Lüthje P, Tanninen S (2003) Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients. Arch Orthop Trauma Surg 123:551–554CrossRefPubMed
11.
Garcia AE, Bonnaig JV, Yoneda ZT, Richards JE, Ehrenfeld JM, Obremskey WT, Jahangir AA, Sethi MK (2012) Patient variables which may predict length of stay and hospital costs in elderly patients with hip fracture. J Orthop Trauma 26:620–623CrossRefPubMed
12.
Loures FB, Chaoubah A, Oliveira VM, Almeida AM, Campos EM, Paiva EP (2015) Economic analysis of surgical treatment of hip fracture in older adults. Rev Saude Publica 49:12CrossRefPubMedPubMedCentral
13.
Petersen MB, Jorgensen HL, Hansen K, Duus BR (2006) Factors affecting postoperative mortality of patients with displaced femoral neck fracture. Injury 37:705–711CrossRefPubMed
14.
Richmond J, Aharonoff GB, Zuckerman JD, Koval KJ (2003) Mortality risk after hip fracture. J Orthop Trauma 17:53–56CrossRefPubMed
15.
Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD (1997) Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma 11:162–165CrossRefPubMed
16.
Berggren M, Stenvall M, Englund U, Olofsson B, Gustafson Y (2016) Co-morbidities, complications and causes of death among people with femoral neck fracture—a three-year follow-up study. BMC Geriatr 16:120CrossRefPubMedPubMedCentral
17.
Roche JJW (2015) Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 331:1374CrossRef
18.
Tosteson AN, Gottlieb DJ, Radley DC, Fisher ES, Melton LJ 3rd (2007) Excess mortality following hip fracture: the role of underlying health status. Osteoporos Int 18:1463–1472CrossRefPubMedPubMedCentral
19.
Clayer MT, Bauze RJ (1989) Morbidity and mortality following fractures of the femoral neck and trochanteric region: analysis of risk factors. J Trauma 29:1673–1678CrossRefPubMed
20.
Todd CJ, Freeman CJ, Camilleri-Ferrante C, Palmer CR, Hyder A, Laxton CE, Parker MJ, Payne BV, Rushton N (1995) Differences in mortality after fracture of hip: the East Anglian audit. BMJ 310:904–908CrossRefPubMedPubMedCentral
21.
Wehren LE, Hawkes WG, Orwig DL, Hebel JR, Zimmerman SI, Magaziner J (2003) Gender differences in mortality after hip fracture: the role of infection. J Bone Miner Res 18:2231–2237CrossRefPubMed
22.
Roberts SE, Goldacre MJ (2003) Time trends and demography of mortality after fractured neck of femur in an English population, 1968–98: database study. BMJ 327:771–775CrossRefPubMedPubMedCentral
23.
Castronuovo E, Pezzotti P, Franzo A, Di Lallo D, Guasticchi G (2011) Early and late mortality in elderly patients after hip fracture: a cohort study using administrative health databases in the Lazio region, Italy. BMC Geriatr 11:37CrossRefPubMedPubMedCentral
24.
Franzo A, Francescutti C, Simon G (2005) Risk factors correlated with post-operative mortality for hip fracture surgery in the elderly: a population-based approach. Eur J Epidemiol 20:985–991CrossRefPubMed
25.
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
26.
Mitchell R, Cameron C, McClure R (2016) Quantifying the morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. BMJ Open 6:e013266CrossRefPubMedPubMedCentral
27.
National Centre for Classification in Health (2006) ICD-10-AM, 5th edn. National Centre for Classification in Health, Sydney
28.
Quan H, Li B, Couris C, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173:676–682CrossRefPubMed
29.
Miller T, Lestina D, Smith GS (2001) Injury risk among medically identified alcohol and drug abusers. Alcohol Clin Exp Res 25:54–59CrossRefPubMed
30.
Wan J, Morabito D, Khaw L, Knudson MM, Dicker RA (2006) Mental illness as an independent risk factor for unintentional injury and injury recidivism. J Trauma Acute Care Surg 61:1299–1304CrossRef
31.
32.
33.
Woodward M (2005) Epidemiology: study design and analysis, 2nd edn. Chapman & Hall CRC, Boca Raton
34.
Poor G, Atkinson EJ, O'Fallon WM, Melton LJ 3rd (1995) Determinants of reduced survival following hip fractures in men. Clin Orthop Relat Res 319:260–265
35.
Klop C, Welsing P, Cooper C, Harvey NC, Elders PJ, Bijlsma JW, Leufkens HG, de Vries F (2014) Mortality in British hip fracture patients, 2000–2010: a population-based retrospective cohort study. Bone 66:171–177CrossRefPubMed
36.
Jiang HX, Majumdar SR, Dick DA, Moreau M, Raso J, Otto DD, Johnston DW (2005) Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patients with hip fractures. J Bone Miner Res 20:494–500CrossRefPubMed
37.
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
38.
Endo Y, Aharonoff GB, Zuckerman JD, Egol KA, Koval KJ (2005) Gender differences in patients with hip fracture: a greater risk of morbidity and mortality in men. J Orthop Trauma 19:29–35CrossRefPubMed
39.
Holt G, Smith R, Duncan K, Hutchison JD, Gregori A (2008) Gender differences in epidemiology and outcome after hip fracture: evidence from the Scottish Hip Fracture Audit. J Bone Joint Surg Br 90:480–483CrossRefPubMed
40.
Australian Institute of Health and Welfare (2015) Admitted patient care 2013–14. Australian Institute of Health and Welfare, Canberra
41.
Centre NCG (2011) The management of hip fracture in adults. National Clinical Guideline Centre, London
42.
Australian and New Zealand Hip Fracture Registry Steering Group (2014) Australian and New Zealand guideline for hip fracture care: improving outcomes in hip fracture management of adults. Australian and New Zealand Hip Fracture Registry Steering Group, Sydney
43.
Mitchell R, Cameron C, Bambach M (2014) Data linkage for injury surveillance and research in Australia: perils, pitfalls and potential. Aust N Z J Public Health 38:276–281
44.
Preen D, Holman CD, Spilsbury K, Semmens JB, Brameld KJ (2006) Length of comorbidity lookback period affected regression model performance of administrative health data. J Clin Epidemiol 59:940–946CrossRefPubMed
Metadata
Title
Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study
Authors
Reidar P. Lystad
Cate M. Cameron
Rebecca J. Mitchell
Publication date
01-12-2017
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-017-0359-7

Other articles of this Issue 1/2017

Archives of Osteoporosis 1/2017 Go to the issue

Original Article

Impact of air pollution on vitamin D deficiency and bone health in adolescents

Original Article

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study

Letter

Effects of acupuncture on quality of life and pain in patients with osteoporosis—a pilot randomized controlled trial: reply to comments by Moran et al.

Original Article

Fragility fractures at Auckland City Hospital: we can do better

Original Article

Trends in and relation between hip fracture incidence and osteoporosis medication utilization and prices in Estonia in 2004–2015

Original Article

Prevalence and risk factors associated with glucocorticoid-induced osteoporosis in Chinese patients with rheumatoid arthritis