Skip to main content

Advertisement

Log in

Time trends of mortality after first hip fractures

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

A register-based study including 2,674 first hip fracture patients from 1987–1996 investigated if the mortality after hip fracture was associated with time trend and fracture type. Despite significantly increasing age at admission no changing time trend of mortality was observed, nor was the mortality linked to the kind of fracture suffered.

Introduction and hypothesis

A retrospective cohort study was performed to investigate if the mortality of first hip fracture patients was associated with time trend and fracture type. The hypotheses were that cumulative mortality would remain unchanged and there would be no difference in mortality between cervical and pertrochanteric patients.

Methods

Study material was obtained by record linkage of excerpts from two computerized national health registers. First hip fractures were identified indirectly by searching the files ten years before the date of admission. The period 1987–1996 saw inclusion of 2,674 patients aged 50 years and older (average follow-up 2.6 years). Statistics: Weighted regression analysis, χ 2 test, and t test.

Results

Cumulative mortality did not change significantly (P > 0.05). Weighted average cumulative mortality was 9% (95% CI, 7.9–10.1) at 1 month, 15.5% (95% CI, 14.1–16.8) at 3 months, 26.5% (95% CI, 24.7–28.3) at 1 year, and 36.2% (95% CI, 34.1–38.3) at 2 years. Cervical and pertrochanteric first hip fracture patients did not have significantly different mortality rates (P > 0.05).

Conclusion

No changing time trend of mortality after first hip fracture was observed despite significantly increasing age at admission, nor was the mortality linked to the kind of fracture suffered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413

    Article  PubMed  CAS  Google Scholar 

  2. Kannus P, Parkkari J, Sievanen H, Heinonen A, Vuori I, Jarvinen M (1996) Epidemiology of hip fractures. Bone 18(Suppl 1):57S–63S

    Article  PubMed  CAS  Google Scholar 

  3. Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902

    Article  PubMed  CAS  Google Scholar 

  4. Nurmi I, Narinen A, Luthje P, Tanninen S (2003) Cost analysis of hip fracture treatment among the elderly for the public health services: a 1-year prospective study in 106 consecutive patients. Arch Orthop Trauma Surg 123:551–554

    Article  PubMed  Google Scholar 

  5. Schroder HM (1991) The cost of hospitalizing hip fracture patients has increased despite shorter hospitalization time. Injury 22:135–138

    Article  PubMed  CAS  Google Scholar 

  6. Zethraeus N, Stromberg L, Jonsson B, Svensson O, Ohlen G (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68:13–17

    Article  PubMed  CAS  Google Scholar 

  7. Zethraeus N, Gerdtham UG (1998) Estimating the costs of hip fracture and potential savings. Int J Technol Assess Health Care 14:255–267

    PubMed  CAS  Google Scholar 

  8. Melton LJ 3rd, Therneau TM, Larson DR (1998) Long-term trends in hip fracture prevalence: the influence of hip fracture incidence and survival. Osteoporos Int 8:68–74

    Article  PubMed  Google Scholar 

  9. Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am 77:1551–1556

    PubMed  CAS  Google Scholar 

  10. McColl A, Roderick P, Cooper C (1998) Hip fracture incidence and mortality in an English Region: a study using routine National Health Service data. J Public Health Med 20:196–205

    PubMed  CAS  Google Scholar 

  11. Fisher ES, Baron JA, Malenka DJ, Barrett JA, Kniffin WD, Whaley FS et al (1991) Hip fracture incidence and mortality in New England. Epidemiology 2:116–122

    Article  PubMed  CAS  Google Scholar 

  12. Bredahl C, Nyholm B, Hindsholm KB, Mortensen JS, Olesen AS (1992) Mortality after hip fracture: results of operation within 12 h of admission. Injury 23:83–86

    Article  PubMed  CAS  Google Scholar 

  13. Schroder HM, Erlandsen M (1993) Age and sex as determinants of mortality after hip fracture: 3,895 patients followed for 2.5–18.5 years. J Orthop Trauma 7:525–531

    Article  PubMed  CAS  Google Scholar 

  14. Jensen JS, Tondevold E (1979) Mortality after hip fractures. Acta Orthop Scand 50:161–167

    PubMed  CAS  Google Scholar 

  15. Stavrou ZP, Erginousakis DA, Loizides AA, Tzevelekos SA, Papagiannakos KJ (1997) Mortality and rehabilitation following hip fracture. A study of 202 elderly patients. Acta Orthop Scand Suppl 275:89–91

    PubMed  CAS  Google Scholar 

  16. White BL, Fisher WD, Laurin CA (1987) Rate of mortality for elderly patients after fracture of the hip in the 1980’s. J Bone Joint Surg Am 69:1335–1340

    PubMed  CAS  Google Scholar 

  17. Wolinsky FD, Fitzgerald JF, Stump TE (1997) The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study. Am J Public Health 87:398–403

    Article  PubMed  CAS  Google Scholar 

  18. Kreutzfeldt J, Haim M, Bach E (1984) Hip fracture among the elderly in a mixed urban and rural population. Age Ageing 13:111–119

    Article  PubMed  CAS  Google Scholar 

  19. Forsen L, Sogaard AJ, Meyer HE, Edna T, Kopjar B (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10:73–78

    Article  PubMed  CAS  Google Scholar 

  20. Boereboom FT, Raymakers JA, Duursma SA (1992) Mortality and causes of death after hip fractures in The Netherlands. Neth J Med 41:4–10

    PubMed  CAS  Google Scholar 

  21. Elliott J, Beringer T, Kee F, Marsh D, Willis C, Stevenson M (2003) Predicting survival after treatment for fracture of the proximal femur and the effect of delays to surgery. J Clin Epidemiol 56:788–795

    Article  PubMed  CAS  Google Scholar 

  22. Farahmand BY, Michaelsson K, Ahlbom A, Ljunghall S, Baron JA, Swedish Hip Fracture Study Group (2005) Survival after hip fracture. Osteoporos Int 16:1583–1590

    Article  PubMed  Google Scholar 

  23. Meyer HE, Tverdal A, Falch JA, Pedersen JI (2000) Factors associated with mortality after hip fracture. Osteoporos Int 11:228–232

    Article  PubMed  CAS  Google Scholar 

  24. Magaziner J, Lydick E, Hawkes W, Fox KM, Zimmerman SI, Epstein RS et al (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87:1630–1636

    PubMed  CAS  Google Scholar 

  25. Muraki S, Yamamoto S, Ishibashi H, Nakamura K (2006) Factors associated with mortality following hip fracture in Japan. J Bone Miner Metab 24:100–104

    Article  PubMed  Google Scholar 

  26. Richmond J, Aharonoff GB, Zuckerman JD, Koval KJ (2003) Mortality risk after hip fracture. J Orthop Trauma 17:53–56

    Article  PubMed  Google Scholar 

  27. Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248–1250

    Article  PubMed  CAS  Google Scholar 

  28. Cornwall R, Gilbert MS, Koval KJ, Strauss E, Siu AL (2004) Functional outcomes and mortality vary among different types of hip fractures: a function of patient characteristics. Clin Orthop Relat Res 425:64–71

    Article  PubMed  Google Scholar 

  29. Hannan EL, Magaziner J, Wang JJ, Eastwood EA, Silberzweig SB, Gilbert M et al (2001) Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA 285:2736–2742

    Article  PubMed  CAS  Google Scholar 

  30. Kotzan JA, Martin BC, Reeves JH, Wade W (1999) The impact of race and fractures on mortality in a postmenopausal Medicaid population. Clin Ther 21:1988–2000

    Article  PubMed  CAS  Google Scholar 

  31. Eiskjaer S, Ostgard SE, Jakobsen BW, Jensen J, Lucht U (1992) Years of potential life lost after hip fracture among postmenopausal women. Acta Orthop Scand 63:293–296

    PubMed  CAS  Google Scholar 

  32. Parker MJ, Anand JK (1991) What is the true mortality of hip fractures? Public Health 105:443–446

    Article  PubMed  CAS  Google Scholar 

  33. Giversen IM (2006) Time trends of age-adjusted incidence rates of first hip fractures: a register-based study among older people in Viborg County, Denmark, 1987–1997. Osteoporos Int 7:552–564

    Article  Google Scholar 

  34. Schroder HM, Petersen KK, Erlandsen M (1993) Occurrence and incidence of the second hip fracture. Clin Orthop 289:166–169

    PubMed  Google Scholar 

  35. Madhok R, Melton LJ 3rd, Atkinson EJ, O’Fallon WM, Lewallen DG (1993) Urban vs rural increase in hip fracture incidence. Age and sex of 901 cases 1980–89 in Olmsted County, U.S.A. Acta Orthop Scand 64:543–548

    PubMed  CAS  Google Scholar 

  36. Endo Y, Aharonoff GB, Zuckerman JD, Egol KA, Koval KJ (2005) Gender differences in patients with hip fracture: a greater risk of morbidity and mortality in men. J Orthop Trauma 19:29–35

    Article  PubMed  Google Scholar 

  37. Foss NB, Kehlet H (2005) Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth 94:24–29

    Article  PubMed  CAS  Google Scholar 

  38. Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C et al (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42

    Article  PubMed  CAS  Google Scholar 

  39. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882

    Article  PubMed  CAS  Google Scholar 

  40. Mosbech J, Jorgensen J, Madsen M, Rostgaard K, Thornberg K, Poulsen TD (1995) The national patient registry. Evaluation of data quality. Ugeskr Laeger 157:3741–3745

    PubMed  CAS  Google Scholar 

  41. Jurgensen HJ, Frolund C, Gustafsen J, Mosbech H, Guldhammer B (1984) Registration of diagnoses in a national patient register. Preliminary assessment of the validity of the register. Ugeskr Laeger 146:3303–3308

    PubMed  CAS  Google Scholar 

  42. Wille-Jorgensen PA, Meisner S (1997) The validity of data in registration of operations. A quality analysis. Ugeskr Laeger 159:7328–7330

    PubMed  CAS  Google Scholar 

  43. Juel K, Helweg-Larsen K (1999) The Danish registers of causes of death. Dan Med Bull 46:354–357

    PubMed  CAS  Google Scholar 

  44. Storm HH, Michelsen EV, Clemmensen IH, Pihl J (1997) The Danish Cancer Registry-history, content, quality and use. Dan Med Bull 44:535–539

    PubMed  CAS  Google Scholar 

  45. Schroder HM, Andreassen MD, Villadsen I, Sorensen JG, Erlandsen M (1995) Increasing age-specific incidence of hip fractures in a Danish municipality. Dan Med Bull 42:109–111

    PubMed  CAS  Google Scholar 

  46. Statistics Denmark. Tabel 30. Middellevetid efter doedelighedserfaringerne (Table 30. Mean life expectancy according to the mortality experiences). Available at: http://www.statistikbanken.dk, Accessed August 28, 2006

  47. Bronnum-Hansen H (2005) Health expectancy in Denmark, 1987–2000. Eur J Public Health 15:20–25

    Article  PubMed  Google Scholar 

  48. Statistics Denmark. Population statistics. Available at: http://www.statistikbanken.dk, Accessed July 23, 2006

Download references

Grants and Acknowledgments

This study was conducted as a part of my education at the Master of Public Health Program at Aarhus University. Professor Michael Vaeth, PhD, Department of Biostatistics, University of Aarhus, was my advisor and provided statistical support. Lecturer Svend Juul, MD, Department of Epidemiology, University of Aarhus, provided technical advice on computer programming. I am grateful for their contributions.

The Viborg County Research Foundation for Social and Health Issues, The Health Administration of Viborg County, Hans and Nora Buchard’s Foundation, and The Foundation of Alfred Helsted, chief physician and DMSc, and Eli Moller, DMSc supported the study financially.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to I. M. Giversen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giversen, I.M. Time trends of mortality after first hip fractures. Osteoporos Int 18, 721–732 (2007). https://doi.org/10.1007/s00198-006-0300-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-006-0300-1

Keywords

Navigation