Abstract
SummaryWe used statistical approaches to calculate 1-year mortality rates and reveal the relationship between age and the 1-year mortality rate after hip fracture based on data from mainland China between the years 2000 and 2018.IntroductionData on the 1-year mortality rates after hip fracture in mainland China remain limited and localized. We aimed to analyze the 1-year mortality rates and reveal the variations in 1-year mortality by age after hip fracture based on data from mainland China.MethodsWe searched PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed for all relevant articles in English or Chinese to estimate the 1-year mortality rates after hip fracture in mainland China. A random-effects meta-analysis model was fitted to pool the overall 1-year mortality rates. A multilevel mixed-effects meta-regression model was developed. Based on the final model, the age-specific 1-year mortality rates after hip fracture in mainland China were generated.ResultsThe pooled estimate of the 1-year mortality rate was 13.96% after hip fracture (95% CI 12.26 to 15.86%), 17.47% after femoral intertrochanteric fracture (95% CI 14.29 to 21.20%), and 9.83% after femoral neck fracture (95% CI 6.96 to 13.72%) between the years 2000 and 2018. We found that the 1-year mortality rates ranged from 2.65% (95% CI 1.76 to 3.99%) in those aged 50~54 years to 28.91% (95% CI 24.23 to 34.30%) in those aged 95~99 years after hip fracture; ranged from 1.73% (95% CI 0.58 to 4.99%) in those aged 50~54 years to 50.11% (95% CI 46.03% to 53.97%) in those aged 95~99 years after femoral intertrochanteric fracture; and ranged from 1.66% (95% CI 1.31 to 2.11%) in those aged 60~64 years to 37.71% (95% CI 27.92 to 48.63%) in those aged 95~99 years after femoral neck fracture.ConclusionIn this systematic review and meta-analysis, we calculated the 1-year mortality rate after hip fracture in mainland China and found that this rate was lower than that in most countries. We also estimated the age-specific mortality rates for different age groups after hip fracture. These findings will be beneficial for the prevention and treatment of hip fracture in mainland China.
Highlights
Hip fracture is one of the most devastating consequences of osteoporosis [1, 2] and is becoming one of the most important public health problems in the world [3]
We aimed to develop epidemiological models to reveal the variations in 1-year mortality rate by age for hip fracture, femoral intertrochanteric fracture, and femoral neck fracture based on these data from mainland China
The 54 studies included in this meta-analysis involved 22,817 Chinese individuals in 13 provinces, 3 municipalities, and 1 autonomous region, covering all of the six regions in mainland China (Fig. 2)
Summary
Hip fracture is one of the most devastating consequences of osteoporosis [1, 2] and is becoming one of the most important public health problems in the world [3]. Data about the mortality risk and rates of hip fractures are available abroad and have contributed to the efforts and attention that national and local policymakers have devoted to improving patients’ healthcare quality and safety [9]. Data about mortality rate after hip fracture in mainland China remain limited and localized. A growing number of population-based studies about the 1-year mortality rates after hip fracture were conducted in local areas in mainland China during the years 2000 and 2018. These studies were restricted to specific geographic and demographic features and could not represent the overall Chinese population. It is feasible to conduct a systematic synthesis of the data from population-based studies and explore the 1year mortality rates after hip fracture from an epidemiological modeling approach
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