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Osteoporosis International
Published in: Osteoporosis International 9/2016

Open Access 01-09-2016 | Original Article

The impact of social deprivation on mortality following hip fracture in England and Wales: a record linkage study

Authors: K. Thorne, A. Johansen, A. Akbari, J. G. Williams, S. E. Roberts

Published in: Osteoporosis International | Issue 9/2016

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Abstract

Summary

We used routine hospital data to investigate whether socially deprived patients had an increased risk of dying following hip fracture compared with affluent patients. We found that the most deprived patients had a significantly increased risk of dying at 30, 90 and 365 days compared with the most affluent patients.

Introduction

To identify whether social deprivation has any effect on mortality risk after emergency admission with hip fracture and to determine whether any increased mortality observed among deprived groups was associated with patient and hospital-related factors.

Methods

We used routine, linked hospital inpatient and mortality data for emergency admissions with a hip fracture in both England and Wales between 2004 and 2011. Mortality rates at 30, 90 and 365 days were reported. Logistic regression was used to identify any significant increases in mortality with higher levels of social deprivation and the influence of other risk factors on any increased mortality among the most deprived group.

Results

Mortality rates at 30, 90 and 365 days were 9.3, 17.4 and 29.0 % in England and 8.3, 16.1 and 27.9 % in Wales. Social deprivation was significantly associated with increased mortality in the most deprived quintile compared with the least deprived quintile at 30, 90 and 365 days in England (OR = 1.187, 1.185 and 1.154, respectively) and at 90 and 365 days in Wales (1.135 and 1.203). There was a little interaction between deprivation and other risk factors influencing 30- and 365-day mortality except for patient age, pre-fracture residence and hospital size.

Conclusions

We demonstrated a positive association between social deprivation and increased mortality at 30 days post-admission for hip fracture in both England and Wales that was still evident at 90 and 365 days. We found little influence of other factors on social inequalities in mortality risk at 30 and 365 days post-admission.
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Metadata
Title
The impact of social deprivation on mortality following hip fracture in England and Wales: a record linkage study
Authors
K. Thorne
A. Johansen
A. Akbari
J. G. Williams
S. E. Roberts
Publication date
01-09-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 9/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3608-5

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