Gender and Race/Ethnicity Differences in Hip Fracture Incidence, Morbidity, Mortality, and Function
- Robert S. Sterling
- … show all 1 hide
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Hip fracture is an international public health problem. Worldwide, approximately 1.5 million hip fractures occur per year, with roughly 340,000 in the United States in individuals older than 65 years. In 2050, there will be an estimated 3.9 million fractures worldwide, with more than 700,000 in the United States. However, whether there are disparities in morbidity, mortality, and function between men and women or between races/ethnicities is unclear.
The purpose of this article is to review the gender and racial/ethnicity differences in hip fracture epidemiology, mortality, and function and to ask what more information is needed and how can it be attained.
A PubMed literature review was performed and appropriate articles selected for inclusion in the review.
Where are we now?
Overall, men with hip fracture are younger, are less healthy, and have a higher postoperative mortality and morbidity. African American and Hispanics patients with hip fractures are younger than whites and have a higher incidence of fracture in men. Non-Hispanic black, Hispanic, and Asian race/ethnicity were all associated with higher odds of discharge home but a longer stay when discharged to rehabilitation.
Where do we need to go?
Expanded knowledge of the influence of gender and race/ethnicity on hip fracture epidemiology, mortality, and outcomes is necessary.
How do we get there?
Additional focused research on gender and racial/ethnic differences in patients with hip fractures is needed. Improving database capture of race/ethnicity data will aid in population studies. Finally, journal editors should require authors to include gender and race/ethnicity data or explain the absence of this information.
- Arinzon Z, Shabat S, Peisakh A, Gepstein R, Berner YN. Gender differences influence the outcome of geriatric rehabilitation following hip fracture. Arch Gerontol Geriatr. 2010;50:86–91. CrossRef
- Becker C, Crow S, Toman J, Lipton C, McMahon DJ, Macaulay W, Siris E. Characteristics of elderly patients admitted to an urban tertiary care hospital with osteoporotic fractures: correlations with risk factors, fracture type, gender and ethnicity. Osteoporosis Int. 2006 17:410–416. CrossRef
- Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB. Incidence and mortality of hip fractures in the United States. JAMA. 2009;302:1573–1579. CrossRef
- Cauley JA. The determinants of fracture in men. J Musculoskel Neuron Interact. 2002;2:220–221.
- DeFrances CJ, Podgornik MN. 2004 National Hospital Discharge Survey: annual summary with detailed diagnosis and procedure data. Advance data from vital and health statistics. 2006. Available at: http://www.cdc.gov/nchs/data/ad/ad371.pdf. Accessed March 1, 2010.
- Di Monaco M, Di Monaco R, Manca M, Cavanna A. Functional recovery and length of stay after recurrent hip fracture. Am J Phys Med Rehabil. 2002;81:86–89. CrossRef
- Endo Y, Aharonoff GB, Zuckerman JD, Egol KA, Koval KJ. Gender differences in patients with hip fracture: a greater risk of morbidity and mortality in men. J Orthop Trauma. 2005;19:29–35. CrossRef
- Farmer ME, White LR, Brody JA, Bailey KR. Race and sex differences in hip fracture incidence. Am J Public Health. 1984;74:1374–1380. CrossRef
- Fox KM, Hawkes WG, Hebel JR, Felsenthal G, Clark M, Zimmerman SI, Kenzora JE, Magaziner J. Mobility after hip fracture predicts health outcomes. J Am Geriatr Soc. 1998;46:169–173.
- Fransen M, Woodward M, Norton R, Robinson E, Butler M, Campbell AJ. Excess mortality or institutionalization after hip fracture: men are at greater risk than women. J Am Geriatr Soc. 2002;50:685–690. CrossRef
- Graham JE, Chang PF, Bergés IM, Granger CV, Ottenbacher KJ. Race/ethnicity and outcomes following inpatient rehabilitation for hip fracture. J Gerontol A Biol Sci Med Sci. 2008;63:860–866.
- Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int. 1997;7:407–413. CrossRef
- Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Vlekeniers B, Boonen S. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152:380–390.
- Hawkes WG, Wehren L, Orwig D, Hebel JR, Magaziner J. Gender differences in functioning after hip fracture. J Gerontol A Biol Sci Med Sci. 2006;61:495–499.
- Holt G, Smith R, Duncan K, Hutchison JD, Gregori A. Gender differences in epidemiology and outcome after hip fracture: evidence from the Scottish Hip Fracture Audit. J Bone Joint Surg Br. 2008;90:480–483. CrossRef
- Jacobson SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA. Race and sex differences in mortality following fracture of the hip. Am J Public Health. 1992;82:1147–1150. CrossRef
- Kannegaard PN, van der Mark S, Eiken P, Abrahamsen B. Excess mortality in men compared with women following a hip fracture: national analysis of comedications, comorbidity and survival. Age Aging. 2010;39:203–209. CrossRef
- Koval KJ, Skovron ML, Aharnoff GB, Zuckerman JD. Predictors of functional recovery after hip fracture in the elderly. Clin Orthop Relat Res. 1998;348:22–28.
- Lieberman D, Lieberman D. Rehabilitation following hip fracture surgery: a comparative study of females and males. Disabil Rehabil. 2004;26:85–90. CrossRef
- Löfman O, Berglund K, Larsson L, Toss G. Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int. 2002;13:18–25. CrossRef
- Lu-Yao GL, Baron JA, Barrett JA, Fisher ES. Treatment and survival among elderly Americans with hip fractures: a population-based study. Am J Public Health. 1994;84:1287–1291. CrossRef
- Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45:M101–M107.
- Nguyen-Oghalai TU, Kuo Y, Wu H, Shokar NK, Grecula M, Tincher S, Ottenbacher KJ. The impact of race/ethnicity of preoperative time to hip stabilization procedure after hip fracture. South Med J. 2010;103:414–418. CrossRef
- Orwig DL, Chan J, Magaziner J. Hip fracture and its consequences: differences between man and women. Orthop Clin North Am. 2006;37:611–622. CrossRef
- Pande I, Scott, DL, O’Neill TW, Pritchard C, Woolf AD, Davis MJ. Quality of life, morbidity, and mortality after low trauma hip fracture in men. Ann Rheum Dis. 2006;65:87–92. CrossRef
- Penrod JD, Litke A, Hawkes WG, Magaziner J, Doucette JT, Koval KJ, Silberzweig SB, Egol KA, Siu AL. The association of race, gender, and comorbidity with mortality and function after hip fracture. J Gerontol A Biol Sci Med Sci. 2008;63:867–872.
- Poór G, Atkinson EJ, O’Fallon WM, Melton LJ 3rd. Determinants of reduced survival following hip fractures in men. Clin Orthop Relat Res. 1995;319:260–265.
- Pratt WB, Holloway JM. Incidence of hip fracture in Alaska Inuit people: 1979–89 and 1996–99. Alaska Med. 2001;43:2–5.
- Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331:1374. CrossRef
- Ross JS, Oakes SL, Wood RC, Espino DV. Hip fractures among hospitalized Mexican Americans. South Med J. 2005;98:S55–S56. CrossRef
- Salamon E, Leslie WD, Metge CJ, Dale J, Yuen CK. Increased incidence of hip fractures in American Indians residing in Northern Latitudes. J Bone Miner Res. 1997;12:S139.
- Samuelsson B, Hedström MI, Ponzer S, Sönderqvist A, Samnegard E, Thorngren KG, Cederholm T, Saaf M, Dalen N. Gender differences and cognitive aspects on functional outcome after hip fracture—a 2 years’ follow-up of 2134 patients. Age Ageing. 2009;38:686–692. CrossRef
- Schroder HM, Erlandsen M. Age and sex as determinants of mortality after hip fracture: 3,895 patients followed for 2.5–18.5 years. J Orthop Trauma. 1993;7:525–531. CrossRef
- Wehren LE, Hawkes WG, Orwig DL, Hebel JR, Zimmerman SI, Magaziner J. Gender differences in mortality after hip fracture: the role of infection. J Bone Mineral Res. 2003;18:2231–2237. CrossRef
- Gender and Race/Ethnicity Differences in Hip Fracture Incidence, Morbidity, Mortality, and Function
Clinical Orthopaedics and Related Research®
Volume 469, Issue 7 , pp 1913-1918
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, S11B, Baltimore, MD, 21201, USA