Abstract
BackgroundThe high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population.MethodsRecords of 428 consecutive hip fracture patients were collected on a population-basis and data on the general population comprising all Finns 65 years of age or older were collected on a cohort-basis. Cause of death was classified as follows: malignant neoplasms, dementia, circulatory disease, respiratory disease, digestive system disease, and other.ResultsMean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the follow-up, age-adjusted mortality after hip fracture surgery was higher in men than in women with hazard ratio (HR) 1.55 and 95% confidence interval (95% CI) 1.21-2.00. Among hip surgery patients, the most common causes of death were circulatory diseases, followed by dementia and Alzheimer's disease. After hip fracture, men were more likely than women to die from respiratory disease, malignant neoplasm, and circulatory disease. During the follow-up, all-cause age- and sex-standardized mortality after hip fracture was 3-fold higher than that of the general population and included every cause-of-death category.ConclusionDuring the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.
Highlights
The high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied
Excess mortality after fracture may be due to the individual characteristics of the person sustaining the hip fracture [8]; e.g., low-bone density is associated with increased non-trauma mortality, even without fractures
A total of 428 hip fracture patients that were eligible for this study were operated on between January 1, 1999 and December 31, 2000, and the follow-up lasted until December 31, 2007
Summary
The high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population. Factors associated with the risk of falling and sustaining osteoporotic fractures may be responsible for the excess mortality [1,7]. Excess mortality after fracture may be due to the individual characteristics of the person sustaining the hip fracture [8]; e.g., low-bone density is associated with increased non-trauma mortality, even without fractures. Further analysis of mortality and cause of death is important to identify the risk factors for death following trauma and to anticipate complications [9]
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