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Risk factors for subsequent hip fractures and fatality after an initial hip fracture in Korea: using nationwide claims data

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Abstract

Summary

In this study, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men.

Introduction

The purpose of this study was to analyze the risk factors for subsequent hip fractures and fatality after an initial hip fracture among Koreans older than 50 years of age using information in the national claims database.

Methods

Our study was conducted using data from the Korean National Health Insurance Service database from 2007 to 2016. A total of 16,915 Korean patients aged ≥ 50 years with a first hip fracture in 2012 were followed for 4 years. Data on fracture, comorbidity, and prescription variables were retrieved from the national registry. The Cox proportional hazards model was used to identify the risk factors affecting subsequent hip fractures and fatality after the initial hip fracture.

Results

A total of 952 patients had subsequent hip fractures, and 6793 patients died. The cumulative incidence rates were 1.3% after 1 year and 5.6% after 4 years. Old age, renal disease, dementia, and Parkinson’s disease were associated with a higher risk of subsequent hip fractures. The fatality rate after the initial hip fracture was 1.6 times higher among men than among women. Certain risk factors for fatality, such as pneumonia after fracture, cerebrovascular disease, mild liver disease, renal disease, and malignancy, were more prevalent among men.

Conclusion

During the study period, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men. The gender difference in fatality might be explained by the larger burden of comorbid diseases among men.

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Acknowledgments

This study was supported by the Korean Society for Bone and Mineral Research. This study used the National Health Insurance Database (NHIS-2019-1-169) of the National Health Insurance Service (NHIS).

Author information

Author notes

  1. Jun-Il Yoo and Ha-Young Kim contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea

    Jun-Il Yoo

  2. Department of Internal medicine, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Republic of Korea

    Ha-Young Kim

  3. College of Pharmacy, Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea

    Sunmee Jang

  4. Department of Orthopedic Surgery, College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea

    Young-Kyun Lee

  5. Department of Orthopedic Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-ku, Seoul, 156-755, Republic of Korea

    Yong-Chan Ha

Authors
  1. Jun-Il Yoo
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  2. Ha-Young Kim
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  3. Sunmee Jang
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  4. Young-Kyun Lee
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  5. Yong-Chan Ha
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Corresponding author

Correspondence to Yong-Chan Ha.

Ethics declarations

The study protocol was approved by the institutional review board (IRB) of Wonkwang University Sanbon Hospital (IRB No. WMCSB 201706-64). The requirement for informed consent was waived because the study was based on routinely collected administrative and claims data.

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Yoo, JI., Kim, HY., Jang, S. et al. Risk factors for subsequent hip fractures and fatality after an initial hip fracture in Korea: using nationwide claims data. Arch Osteoporos 15, 165 (2020). https://doi.org/10.1007/s11657-020-00820-6

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  • DOI: https://doi.org/10.1007/s11657-020-00820-6

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