Excess mortality or institutionalization after hip fracture: men are at greater risk than women.
OBJECTIVE
To assess 2-year excess mortality or institutionalization risk associated with hip fracture in community-dwelling people aged 60 and over.


METHODS
Cohort study.


METHODS
Auckland, New Zealand, from July 1991 to February 1996.


METHODS
Five hundred sixty-five community-dwelling older people recently hospitalized with a hip fracture and 782 randomly selected controls, frequency matched for age and gender, living in the same catchment area as the cases.


METHODS
Two-year mortality or institutionalization status.


RESULTS
Over half (52.1%) of male hip fracture cases and 12.4% of male controls were dead or institutionalized, compared with 39.2% of female hip fracture cases and 19.7% of female controls. The odds ratio, adjusted for baseline demographic characteristics, medical status, and physical function, for death or institutionalization was 6.89 (95% confidence interval (CI) = 2.75-17.27) for men and 1.48 (95% CI = 1.02-2.19) for women.


CONCLUSIONS
For both men and women who incur a hip fracture, the risks of dying or being institutionalized within 2 years are higher than for their peers. The independent effect of hip fracture on this outcome was significantly greater for men than women. The marked influences of prefracture health status, physical limitations, and gender on outcome have important implications for preventative strategies.
Fransen
Marlene
M
Institute for International Health, University of Sydney, Australia. mfransen@iih.usyd.edu.au
Woodward
Mark
M
Norton
Robyn
R
Robinson
Elizabeth
E
Butler
Meg
M
Campbell
A John
AJ
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006304:Health Status; D006620:Hip Fractures; D006801:Humans; D007326:Institutionalization; D008297:Male; D009026:Mortality; D009520:New Zealand; D017678:Sex Distribution