Calcified Tissue International

, Volume 95, Issue 3, pp 257–266 | Cite as

Mortality After Hip Fracture in Austria 2008–2011

  • Wolfgang BrozekEmail author
  • Berthold Reichardt
  • Oliver Kimberger
  • Jochen Zwerina
  • Hans Peter Dimai
  • Daniela Kritsch
  • Klaus Klaushofer
  • Elisabeth Zwettler
Original Research


Osteoporosis-related hip fractures represent a substantial cause of mortality and morbidity in industrialized countries like Austria. Identification of groups at high risk for mortality after hip fracture is crucial for health policy decisions. To determine in-hospital, long-term, and excess mortality after osteoporosis-related hip fracture in Austrian patients, we conducted a retrospective cohort analysis of pseudonymized invoice data from Austrian social insurance authorities covering roughly 98 % of the entire population. The data set included 31,668 subjects aged 50 years and above sustaining a hip fracture between July 2008 and December 2010 with follow-up until June 2011, and an age-, gender-, and regionally matched control population without hip fractures (56,320 subjects). Kaplan–Meier and Cox hazard regression analyses served to determine unadjusted and adjusted mortality rates: Unadjusted all-cause 1-year mortality amounted to 20.2 % (95 % CI: 19.7–20.7 %). Males had significantly higher long-term, in-hospital, and excess mortality rates than females, but younger males exhibited lower excess mortality than their female counterparts. Advanced age correlated with increased long-term and in-hospital mortality, but lower excess mortality. Excess mortality, particularly in males, was highest in the first 6 months after hip fracture, but remained statistically significantly elevated throughout the observation period of 3 years. Longer hospital stay per fracture was correlated with mortality reduction in older patients and in patients with more subsequent fractures. In conclusion, more efforts are needed to identify causes and effectively prevent excess mortality especially in male osteoporosis patients.


Hip fracture Osteoporosis Mortality Excess mortality Survival Hospital days 



We thank Katrin Danninger (Oberösterreichische Gebietskrankenkasse), Alexandra Ferdin (Versicherungsanstalt öffentlich Bediensteter), Jana Fischer (Niederösterreichische Gebietskrankenkasse), Peter Haubenberger (Sozialversicherungsanstalt der Gewerblichen Wirtschaft), Michael Hueber (Versicherungsanstalt für Eisenbahnen und Bergbau), Renato Kasseroller (Salzburger Gebietskrankenkasse), Claudia Kastelic (Sozialversicherungsanstalt der Bauern), Tobias Lingenhöle (Vorarlberger Gebietskrankenkasse), Ursula Riess (Kärntner Gebietskrankenkasse), Marianne Schmid (Steiermärkische Gebietskrankenkasse), Cornelia Siess (Wiener Gebietskrankenkasse), and Norbert Thiemann (Tiroler Gebietskrankenkasse) from the Austrian social insurance authorities for provision of the data.

Human and Animal Rights and Informed Consent

The local Ethics Committee approved the study which was performed according to the Declaration of Helsinki.

Supplementary material

223_2014_9889_MOESM1_ESM.pdf (212 kb)
Supplementary material 1 (PDF 211 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Wolfgang Brozek
    • 1
    Email author
  • Berthold Reichardt
    • 2
  • Oliver Kimberger
    • 3
  • Jochen Zwerina
    • 1
  • Hans Peter Dimai
    • 4
  • Daniela Kritsch
    • 1
  • Klaus Klaushofer
    • 1
  • Elisabeth Zwettler
    • 1
  1. 1.Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of the WGKK and AUVA Trauma Center1st Medical Department at Hanusch HospitalViennaAustria
  2. 2.Sickness Fund BurgenlandBurgenländische GebietskrankenkasseEisenstadtAustria
  3. 3.Clinical Department of General Anesthesia and Intensive Care MedicineMedical University of ViennaViennaAustria
  4. 4.Department of Internal Medicine, Division of Endocrinology and MetabolismMedical University of GrazGrazAustria

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