Hip Fractures Increase Mortality Risk in Older Adults

According to a recent study, hip fractures are associated with increased risk of all-cause mortality in older adults.

Researchers evaluated data from 122,808 participants who were divided into 8 cohorts across Europe and the United States, with a median follow-up of 12.6 years. Telephone interviews and questionnaires and national inpatient/fracture registries were used to determine incidences of hip fractures, and death certificates were used to verify death.
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The association between hip fracture and mortality and its magnitude at different time intervals after injury were assessed using Cox proportional hazard models and time-dependent variable methodology. In addition, researchers obtained the effect estimated through a random-effects meta-analysis.

During the study, there were 4273 incidences of hip fractures and 27,999 deaths. Overall, hip fractures were associated with increased risk of all-cause mortality (hazard ratio 2.12).

Their findings showed higher incidences of mortality within the first year after a hip fracture, and that the risk remained elevated long after the initial injury. Hazard ratios for mortality after a hip fracture were 1.89 from 1 to 4 years after injury, 2.15 from 4 to 8 years after injury, and 1.79 for 8 years or more after injury.

In addition, researchers found a stronger association between hip fractures and mortality in men (hazard ratio 2.39) than women (hazard ratio 1.92), although the difference was not significant.

“In this large population-based sample of older persons across eight cohorts, hip fracture was associated with excess short- and long-term all-cause mortality in both sexes,” the researchers concluded.

—Melissa Weiss

Reference:

Katsoulis M, Benetou V, Karapetyan T, et al. Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project [published online January 17, 2017]. Journal of Internal Medicine. doi:10.1111/joim.12586.