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Excess mortality after hip fracture among elderly women in Norway

The HUNT study

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Abstract

Summary

We wanted to study mortality after hip fractures among elderly women in Norway. We found that excess mortality was highest short time after hip fracture, but persisted for several years after the fracture. The excess mortality was not explained by pre-fracture medical conditions.

Introduction

The purpose of the present study was to investigate short and long term mortality after hip fracture, and to evaluate how comorbidity, bone mineral density, and lifestyle factors affect the survival after hip fractures.

Methods

The study cohort emerges from a population-based health survey in the county of Nord-Trøndelag, Norway. Women aged 65 or more at participation at the health survey who sustained a hip fracture after attending the health survey are cases in this study (n = 781). A comparison cohort was constructed based on participants at HUNT 2 with no history of hip fractures (n = 3, 142). Kaplan–Meier survival curves were used to evaluate crude survival, and Cox regression analyses were used to study age-adjusted hazard ratios for mortality and for multivariable analyses involving relevant covariates.

Results

Mean length of follow-up after fracture was 2.8 years. Within the first 3 months of follow-up, 78 (10.0%) of the hip fracture patients died, compared to only 39 (1.7%) in the control group. HR for mortality 3 months after hip fracture was 6.5 (95% CI 4.2–9.6). For the entire follow-up period women who sustained a hip fracture had an HR for mortality of 1.9 (95% CI 1.6–2.3), compared with women without a hip fracture.

Conclusions

We found that elderly women who sustained a hip fracture had increased mortality risk. The excess mortality was highest short time after the fracture, but persisted for several years after the fracture, and was not explained by pre-fracture medical conditions.

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References

  1. Ahmed LA et al (2006) Validation of the Cummings’ risk score; how well does it identify women with high risk of hip fracture: the Tromso Study. Eur J Epidemiol 21(11):815–822

    Article  PubMed  Google Scholar 

  2. Kanis JA et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11(8):669–674

    Article  PubMed  CAS  Google Scholar 

  3. Fitts WT et al (1959) Life expectancy after fracture of the hip. Surg Gynecol Obstet 108:7–12

    Google Scholar 

  4. Jitapunkul S, Yuktanandana P (2000) Consequences of hip fracture among Thai women aged 50 years and over: a prospective study. J Med Assoc Thai 83(12):1447–1451

    PubMed  CAS  Google Scholar 

  5. Farahmand BY et al (2005) Survival after hip fracture. Osteoporos Int 16(12):1583–1590

    Article  PubMed  Google Scholar 

  6. Petersen MB et al (2006) Factors affecting postoperative mortality of patients with displaced femoral neck fracture. Injury 37(8):705–711

    Article  PubMed  CAS  Google Scholar 

  7. Forsen L et al (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10(1):73–78

    Article  PubMed  CAS  Google Scholar 

  8. Haentjens, P., et al., Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 152(6): 380–390

  9. Empana JP, Dargent-Molina P, Breart G (2004) Effect of hip fracture on mortality in elderly women: the EPIDOS prospective study. J Am Geriatr Soc 52(5):685–690

    Article  PubMed  Google Scholar 

  10. Magaziner J et al (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87(10):1630–1636

    Article  PubMed  CAS  Google Scholar 

  11. Cauley JA et al (2000) Risk of mortality following clinical fractures. Osteoporos Int 11(7):556–561

    Article  PubMed  CAS  Google Scholar 

  12. Robbins JA, Biggs ML, Cauley J (2006) Adjusted mortality after hip fracture: From the cardiovascular health study. J Am Geriatr Soc 54(12):1885–1891

    Article  PubMed  Google Scholar 

  13. 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(3):398–403

    Article  PubMed  CAS  Google Scholar 

  14. Tosteson AN et al (2007) Excess mortality following hip fracture: the role of underlying health status. Osteoporos Int 18(11):1463–1472

    Article  PubMed  CAS  Google Scholar 

  15. Holmen J, Midthjell K, Kruger O, Langhammer A, Holmen TL, Bratberg G, Vatten L, Lund-Larsen P (2003) The Nord-Trondelag Health study 1995–97 (hunt 2): objectives, contents, methods and participation. Norsk Epidemiologi 13(1):19–32

    Google Scholar 

  16. Forsmo S et al (2006) What is the influence of weight change on forearm bone mineral density in peri- and postmenopausal women? The health study of Nord-Trondelag, Norway. Am J Epidemiol 164(9):890–897

    Article  PubMed  Google Scholar 

  17. Forsmo S et al (2005) Forearm bone mineral density in an unselected population of 2,779 men and women–the HUNT Study, Norway. Osteoporos Int 16(5):562–567

    Article  PubMed  Google Scholar 

  18. Forsmo S et al (2001) How do reproductive and lifestyle factors influence bone density in distal and ultradistal radius of early postmenopausal women? The Nord-Trondelag Health Survey, Norway. Osteoporos Int 12(3):222–229

    Article  PubMed  CAS  Google Scholar 

  19. Meyer HE et al (2000) Factors associated with mortality after hip fracture. Osteoporos Int 11(3):228–232

    Article  PubMed  CAS  Google Scholar 

  20. Magaziner J et al (1989) Survival experience of aged hip fracture patients. Am J Public Health 79(3):274–278

    Article  PubMed  CAS  Google Scholar 

  21. Pioli G et al (2006) Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res 18(5):381–387

    PubMed  CAS  Google Scholar 

  22. Johansson C et al (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63(3):190–196

    Article  PubMed  CAS  Google Scholar 

  23. Browner WS et al (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of Osteoporotic Fractures Research Group. Lancet 338(8763):355–358

    Article  PubMed  CAS  Google Scholar 

  24. Giversen IM (2007) Time trends of mortality after first hip fractures. Osteoporos Int 18(6):721–732

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Nord-Trøndelag Health Study (The HUNT Study) is a collaboration between HUNT Research Centre, Faculty of Medicine at the Norwegian University of Science and Technology (NTNU, Verdal), Norwegian Institute of Public Health and Nord-Trøndelag County Council.

Conflicts of interest

Arnulf Langhammer is joint owner of a DXA bone densitometer as part of a general practice. None of the four other authors have any conflicts of interest.

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Authors and Affiliations

  1. Department of Public Health and General Practice, Norwegian University of Science and Technology, PB 8905, 7491, Trondheim, Norway

    A. B. Grønskag, P. Romundstad, S. Forsmo & B. Schei

  2. Department of Radiology, Levanger Hospital, Levanger, Norway

    A. B. Grønskag

  3. HUNT research centre, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway

    A. Langhammer

  4. Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim, Norway

    B. Schei

Authors
  1. A. B. Grønskag
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  2. P. Romundstad
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  3. S. Forsmo
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  4. A. Langhammer
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  5. B. Schei
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Corresponding author

Correspondence to A. B. Grønskag.

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Grønskag, A.B., Romundstad, P., Forsmo, S. et al. Excess mortality after hip fracture among elderly women in Norway. Osteoporos Int 23, 1807–1811 (2012). https://doi.org/10.1007/s00198-011-1811-y

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  • DOI: https://doi.org/10.1007/s00198-011-1811-y

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