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Incidence and all-cause mortality for hip fracture in comparison to stroke, and myocardial infarction: a fifteen years population-based longitudinal study

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Abstract

Purpose

This population-based study investigated the incidence, in-hospital and long-term all-cause mortality, for hip fracture (HipFx), stroke (STR), and myocardial infarction (MI) in residents hospitalized between 2000 and 2014.

Methods

Data about hospitalization were drawn from the administrative discharge database, whereas information about residents and all-cause mortality from the municipality of our town. Patients were followed-up from the first hospital admission until death or study end. For each cause, crude and age-adjusted all-cause mortality of men and women were compared by Mann–Whitney’s test and Poisson models. Separate age-sex adjusted Cox models were estimated and the corresponding adjusted survival curves were drawn.

Results

Among 1292 hospitalizations (of 1109 patients), 434 were for HipFx, 526 for STR, 332 for MI (183 with and 149 without coronary revascularization –MIwCR and MIwoCR, respectively). The incidence of HipFx and STR did not vary over time, MI slightly increasing in men. Age-adjusted in-hospital mortality for HipFx was lower than for STR and MIwoCR in the whole sample and in women (p < 0.001), but not in men. After discharge, men with HipFx had shorter survival and higher crude and age-adjusted mortality rate than women. The estimated HRs(95%CI) in respect to patients with MIwCR (having the lowest mortality) were: 6.11(3.12–11.97), p < 0.001 for HipFx; 5.78(2.93–11.32), p < 0.001 for STR; 2.68(1.27–5.66), p = 0.010 for MIwoCR in the whole sample [HR: 16.58(6.70–40.98) p < 0.001 for HipFx; 7.35(3.01–17.93) p < 0.001 for STR, in men].

Conclusions

HipFx markedly impacts hospital care, and causes high in-hospital and long-term all-cause mortality, comparable to the two commonest non-tumor causes of death.

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Author information

Authors and Affiliations

  1. Units of Internal Medicine, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo, FG, Italy

    Vincenzo Carnevale

  2. Units of Biostatistics, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo, FG, Italy

    Andrea Fontana & Massimiliano Copetti

  3. Units of Endocrinology, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo, FG, Italy

    Alfredo Scillitani

  4. Health Statistics, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo, FG, Italy

    Roberto Sinisi

  5. Department of Experimental Medicine, “Sapienza” University, Rome, Italy

    Elisabetta Romagnoli

Authors
  1. Vincenzo Carnevale
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  2. Andrea Fontana
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  3. Alfredo Scillitani
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  4. Roberto Sinisi
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  5. Elisabetta Romagnoli
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Corresponding author

Correspondence to Vincenzo Carnevale.

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The authors declare they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Vincenzo Carnevale and Andrea Fontana share common responsibility as first authors.

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Carnevale, V., Fontana, A., Scillitani, A. et al. Incidence and all-cause mortality for hip fracture in comparison to stroke, and myocardial infarction: a fifteen years population-based longitudinal study. Endocrine 58, 320–331 (2017). https://doi.org/10.1007/s12020-017-1423-1

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  • DOI: https://doi.org/10.1007/s12020-017-1423-1

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