Second hip fracture in Hong Kong – Incidence, demographics, and mortality

Abstract

ObjectivesThe aim of this study is to investigate the incidence of second hip fractures after a previous hip fracture and subsequent mortality in Chinese men and women. MethodsData of patients aged 65 years or above with operatively treated hip fracture in the years 2000–2011 in Hong Kong were retrieved from Hospital Authority clinical database. During the follow-up period, second contralateral operatively treated hip fractures were identified. The incidence of a second fracture was determined using survival analysis. ResultsA total of 2399 second hip fractures were identified. The cumulative incidence of a second fracture was 1.24% at 1 year and 4.42% at 5 years with 60% of second fractures occurring within 4 years after the initial fracture. In cox regression model, a higher incidence was observed as age increased (hazard ratio [HR], 1.08; P < 0.001). The cumulative mortality at 1 and 5 years after a second fracture was 16.9% and 54.8%, respectively. The median survival after single fracture was 4.9 years, while after a second fracture it was 3.8 years (P < 0.05). Lower survival was observed after the second fracture (HR, 5.44; P < 0.05), in men (HR, 1.91; P < 0.05) and older patients (HR, 1.061; P < 0.05). ConclusionsPatients with history of hip fracture are at high risk to develop a second fracture. Initiation of treatment and fragility fracture prevention program after primary hip fracture should be started in order to reduce second fracture incidence and related mortality.