Adjusted Mortality After Hip Fracture: From the Cardiovascular Health Study

J Am Geriatr Soc. 2006 Dec;54(12):1885-91. doi: 10.1111/j.1532-5415.2006.00985.x.

Abstract

Objectives: To estimate the risk of death associated with hip fracture (HFx), stratifying by sex and time since fracture.

Design: Prospective cohort study compared participants with and without hip fracture, matched on sex, age, race, recruitment period, and time since enrollment.

Setting: The Cardiovascular Health Study, a more-than-15-year longitudinal study of 5,888 older individuals from four U.S. sites.

Participants: Three hundred seventy-nine individuals with HFx were compared with 1,134 without HFx.

Measurements: Extended Cox models were used to estimate mortality hazard ratios (HRs) for different periods after fracture, adjusting for prefracture health.

Results: Age- and race-adjusted excess mortality was 9% in women and 24% in men 1 year after fracture, and 24% in women and 26% men 5 years postfracture. Multivariable-adjusted HRs of mortality associated with HFx in women were 7.1 (95% confidence interval (CI) = 2.3-21.5), 2.1 (95% CI = 1.0-4.1), 1.4 (95% CI = 1.1-2.0), and 1.0 (95% CI = 0.6-1.5) for 0 to 1 months, 2 to 6 months, 7 months to 4 years, and 5 to 8 years, respectively, after index date. In men, respective HRs for the same time periods were 39.9 (95% CI = 5.2-308.7), 3.8 (95% CI = 1.4-10.3), 1.1 (95% CI = 0.7-1.8), and 1.0 (95% CI = 0.3-2.7). HRs adjusted for age and race were 20% to 40% higher.

Conclusion: The risk of mortality was highest in the first 6 months after HFx. In men, the risk of death approximated that of men without HFx after 6 months; in women, a moderately greater risk persisted through the fourth year. Although the mortality pattern was different in women and men, excess mortality 5 years postfracture was similar for both sexes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • Health Status
  • Health Surveys
  • Hip Fractures / complications
  • Hip Fractures / epidemiology*
  • Humans
  • Male
  • Mortality*
  • Multicenter Studies as Topic
  • Proportional Hazards Models
  • Sex Distribution
  • Time Factors
  • United States / epidemiology